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The Autism Program Specialist II is the primary contact for the community concerning the added behavioral health treatment services benefit for Medi-Cal beneficiaries. Responsibilities will include program development, essential building of pieces of programmatic efforts as required by federal and state regulations, training and education to both internal L.A. Care staff and the community at large, and submission of federal and state required reports. On the internal side, this position will need to develop an understanding of how Autism Spectrum Disorder services will be handled in claims and utilization management. A large component of this position would also include reviewing comprehensive diagnostic evaluations and reviewing/approving Behavioral Health Treatment plans. Support the Provider Development Manager in ensuring network adequacy, quality of care and timely services. Participate in countywide multiagency collaboration in preventing duplication of services from various agencies such as Department of Education, Regional Centers, L.A. county DMH, etc.
Job Responsibility
Ensure treatment plan is being followed and progress is being made
Ensure all required covered services and limitations are standardized across necessary departments within L.A. Care Health Services as per regulation
Review Comprehensive Diagnostic Evaluations
Approve/authorize full BHT assessment to establish timely treatment plans
Assist in Continuity of Care
Review Behavioral Health Treatment plans
Assist Utilization Management in prior authorization process
Outreach to members, providers, and Regional Centers
Perform other duties as assigned
Requirements
At least 4 years of experience in Behavioral Health/Health Care-Autism diagnosis, treatment, programs, regulations
Experience in face-to-face case management in the field
Understand the EPSDT process and the eligibility criteria
Excellent verbal, written communication and presentation skills
Proficient in Microsoft Office and computer skills
Board Certified Behavioral Analyst - Active, current and unrestricted California license
Nice to have
Bachelor's Degree
Licensed Clinical Social Worker (LCSW) - Active, current and unrestricted California License
Licensed Marriage and Family Therapy (LMFT) - Active, current and unrestricted California License