Position Summary:

Under the direct supervision of the HCBA Waiver Manager the HCBA Waiver Program Supervisor is responsible for all aspects of planning development and supervision of the Home and Community Based Alternatives (HCBA) MediCal Waiver enrollment process to increase enrollment and maximize utilization of HCBA Waiver services within the community.

The HCBA Waiver Program Supervisor is responsible for supervising and assisting with all initial application screens assigning and coordinating assessments for applicants to the HCBA Waiver program and supervising the activities of Enrollment Specialists the application process. Additionally this position works closely with the community and multiple community agencies to disseminate HCBA program and services information including but not limited to: designing marketing materials creating presentations and assisting with referrals to our program from other agencies.

The HCBA Waiver Program Supervisor directly oversees daytoday operations including but not limited to: employee performance reviews reporting process improvement quality monitoring and change management. Cultivates and maintains communication between HCBA Waiver Team and DHCS SYH department San Diego County Imperial County as well as other relevant community partners.

Essential Functions of the Job:

• Leads coordinates and supervises the HCBA Waiver Enrollment team including monitoring and completing employee performance evaluations and disciplinary action (as needed).
• Assist HCBA Waiver Enrollment Team (Enrollment Team: enrollment specialist and CMT) to conduct HCBA Waiver phone eligibility screenings initial screenings and assigns Care Management Teams to conduct assessments in the home of potential participants. Provides education and enrollment assistance to enrollment team to determine participant needs and eligibility for enrollment.

• Responsible for the overall operation of the HCBA Waiver Program including implementation of all policies quality and production metrics enhanced care management activities while in collaboration with community resources to ensure continuity of care.
• Coordinate all marketing and enrollment activities including coordination with HCBA Waiver staff and other departments who may come into contact with HCBA Waiver eligible participants. Participates in marketing activities in conjunction with and as assigned by the HCBA Waiver Manager and/or Director of Patient Engagement.
• Act as liaison and one of the primary contact persons for enrollment and collaboration with DHCS other Waiver Agencies governmental entities providers and others.
• Provides expertise on treatment adjudication request process claim processes and HCBA Waiver contract and acts as liaison with DHCS and providers on behalf of HCBA Waiver Program
• Works closely with the HCBA Waiver Manager to develop HCBA marketing materials. Provides resources to interested families potential participants community partners and providers.
• Develop and maintain multiple reports to assess and analyze enrollment activities for the purpose of maximizing enrollment as well track and maintain report for the global HCBA Waiver case load (Transfer disenrollment and case load distribution); maintains accurate records of critical incidents and case management outcomes for reporting and analysis.
• Prepares and submits statistical and/or productivity reports daily weekly and/or monthly by predetermined deadlines and as required. Performs quality assurance and continuous quality improvement activities for the department.
• In collaboration with HCBA Waiver Manager develop and monitor project timelines and budgets to ensure that projects are completed on time and within budget constraints.
• Designing and administering training programs for the different positions in the HCBA Waiver program providing expertise in development design identifying training needs and providing recommendation on programs and activities.
• Assign trainers and educators to specific training programs provide them with the necessary training and supervise their activities to ensure complete implementation of all learning initiatives.
• Collects and enters data in internal case log. Generates and submits Monthly and Quarterly Performance Reports as assigned by the HCBA Waiver Manager to the State of California Department of Health Care Services.
• Ensures a positive experience for potential enrollees candidates and their Authorized Representatives. Provides responsive highquality service to patients and others who interact with the HCBA Waiver and enrollment team. Provides accurate complete and up to date information in a courteous efficient and timely manner.
• Ensures compliance with all applicable CMS (Centers for Medicare & Medicaid Services) and California Department of Health Care Services (DHCS) and San Ysidro Health policies rules and regulations.
• Ensure compliance with documentation and maintains records.
• Assists with developing policies procedures and standards for department activities.
• Communicates job expectations with employees to achieve results. Provides performance supervision through coaching counseling and additional resources.
• Responsible for the direct supervision of Administrative Team (Referrals Coordinator(s) Administrative Assistant(s) Enrollment Specialist(s) and others) and MSWs/BSWs utilizing principles and techniques of supervision relating to training direction and evaluation of staff.
• Responsible for hiring training supervising and evaluating assigned staff and daily activities.

Additional Duties and Responsibilities:

• Works independently and as an effective member of the team.
• Manage projects and their respective activities timelines and issues.
• Able to adjust marketing and enrollment strategies as necessary based on data analysis.
• Establish and maintain effective interpersonal relationships with all levels of staff other internal departments outside agencies providers the general public and all referral sources.
• Complies with all department organization and government policies & procedures.
• Attends meetings and training courses as required.
• Leads weekly staff meetings participates on required local trainings and outoftown staff development opportunities when available.
• Adheres to and models SY Healths core values and behaviors of Excellence Empowerment Integrity and Respect.
• Adheres to SY Health and HCBA Waiver attendance and punctuality policies and practices.
• Performs other duties as assigned.
• Adheres and ensures compliance with DHCS and SY Health rules and regulations.

Job Requirements:

Education Required:

Bachelors degree in healthcare social work public health or a related field.

Certifications/Licenses Required:

CA drivers license with appropriate insurance coverage.

Experience and Required Skills:

Minimum of 2 years of experience in a healthcare administration setting with knowledge of:

• Referral and/or nursing billing authorization.
• Health care programs including MediCal eligibility requirements and regulatory guidelines.
• Program management principles and practices in healthcare or social services.
• Communitybased healthcare programs such as EPSDT (Early and Periodic Screening Diagnostic and Treatment) IHSS (InHome Supportive Services) or WPCS (Waiver Personal Care Services).
• Medical terminology.
• Computer proficiency (Microsoft Office programs).
• Ability to multitask.

Verbal and Written Skills Required to Perform the Job:

Good verbal and written communication skills.

Equipment Used:

Computer fax additional software as required.

Working Conditions and Physical Requirements:

Prolonged sitting position walking constant telephone communication. The standard schedule is Monday through Friday 8am to 5pm with flexibility for weekend/evening outreach events as needed sporadically throughout the year. Driving and travel may be required in San Diego and Imperial counties.

Universal Requirements:

Preemployment requirements include I9 physical positive background and reference check results complete application new hire orientation preemployment PPDs.

About Us San Ysidro Health is a Federally Qualified Health Care organization committed to providing high quality compassionate accessible and affordable healthcare services for the entire family. The organization was founded by seven women in search of medical services for their families and community. Almost 50 years later San Ysidro Health now provides innovative care to over 108000 patients through a vast and integrated network of 47 program sites across the county. San Ysidro Health could not serve our patients without the dedication of our passionate and hardworking employees. Apply today and become a part of our missiondriven team! San Ysidro Health has a longstanding commitment to equal employment opportunity for all applicants for employment. Employment decisions including but not limited to those such as employee selection performance evaluation administration of benefits working conditions employee programs transfers position changes training disciplinary action compensation and separations are made without regard to race color religion (including religious dress and grooming) creed national origin nationality citizenship status domestic partnership status ancestry gender affectional or sexual orientation gender identity or expression marital status civil union status family status age mental or physical disability (including AIDS or HIVrelated status) atypical heredity cellular or blood trait of an individual genetic information or refusal to submit to a genetic test or make available the results of a genetic test military status veteran status or any other characteristic protected by applicable federal state or local laws.