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Home My WebLink AboutMINUTES - 07242007 - C.52 TO: BOARD OF SUPERVISORS � �` `; °� Contra F=" `. FROM: LORI GENTLES- Assistant Count ' Y � _ Q Costa 5'V Administrator Director of Human Resources ' County DATE: July 24,::2007 SUBJECT: P300 # 20301- Health. Services Department . SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: Adopt position adjustment Resolution # 20301 to ESTABLISH the classifications of Health Plan Director of Provider Relations and Credentialing (VRG3) [unrepresented] and Health Plan Director of Contracting (VRG2) [unrepresented]: ALLOCATE both classifications to B85 1970 ($7366.88- $8954.49)of the salary schedule, and ADD one position to each classification. FISCAL IMPACT: Upon approval, this action will result in an annual cost of$31,506.00 funded through member premiums and the cancellation of the contract positions. BACKGROUND: The Health Services Department has requested a to establish the classifications of Health Plan Director of Contracting which will be responsible for directing the clinical service provider contract management activities for the health plan, as well as Health Plan Director of Provider Relations and Credentialing; which will be responsible for monitoring all non-clinical provider activities as well as overseeing the credentialing process for all community providers. Both of the above positions are high-level management with responsibility for determining and advocating substantive program policy. They are also responsible for overseeing a major functional area of the health plan. CONSEQUENCE OF NEGATIVE ACTION: If this request is not approved,the department will have to continue to utilize contractors to perform these essential functions. CONTINUED ON ATTACHMENT: / YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMME ON OF BOARD COMMITTEE y APPROVE OTHER SIGNATURE( , ACTION OF BO R ON APPROVED AS RECOMMENDED �_ OTHER VOTE OF SUP ISORS I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON MINUTES OF UNANIMOUS(ABSENTS ) THE BOARD OF SUPERVISORS ON THE DATE SHOWN. AYES: NOES: ABSENT: ABSTAIN: Contact: Shelley Pighin,7-5250(Health Services) Malinda Brown,5-1715(HR) Cc: Health Services Department ATTESTED Human Resources JOHN CUL CLERK OF THE BOARD OF SUPERVISORS BY: f DEPUTY BOARD OF SUPERVISORS AGENDA July 24, 2007 P300 #20301-Health Services Department Adopt position adjustment Resolution #20301 to ESTABLISH the classifications of Health Plan Director of Provider Relations and Credentialing (VRG3) [unrepresented] and Health Plan Director of Contracting (VRG2) [unrepresented]; ALLOCATE both classifications to B85 1970 ($7366.88-$8954.49) of the salary schedule, and ADD one position to each classification. • The Health Services Department has requested to establish the classifications of Health Plan Director of Contracting which will be. responsible for directing the clinical service provider contract management activities for the health plan. As well as Health Plan Director of Provider Relations and Credentialing which will be responsible for monitoring all non-clinical provider activities as well. as overseeing the Credentialing process for all community providers. •. Both of the above positions are high-level management with responsibility for determining and advocating substantive program policy. They are also responsible for overseeing a major functional area of the health plan.. • Upon approval, this action will result in an annual cost of $31,506.00 funded through member premiums and the cancellation of the contract positions. • This action will go into effect the day following Board Action. Submitted By: Malinda Brown, Human Resources Analyst 7/9/07 pploved By: Date Vero ica Hodg"nnelSupervisor Date Contra Costa County Class Code: VRGD HEALTH PLAN DIRECTOR OF PROVIDER RELATIONS AND CREDENTIALING Class specifications are intended to present a descriptive list of the range of duties performed by employees in the class. Class specifications are not intended to reflect all duties performed within this job. DEFINITION: Under general direction, plans, organizes, and directs the 'provider operations and related business affairs of the Contra Costa Health Plan (CCHP); develops, implements, and monitors contracts with providers outside of the Health Services Department's 'delivery system, interdivision agreements within the Health-Services Department, and the credentialing process for community providers; advises the Chief Executive Officer and the Health Plan Governing and Advisory Boards on all policy and operational matters; coordinates provider panel issues and related activities with the administrative staff of.the Contra Costa Regional Medical Center and Health Centers; represents CCHP to federal, state, and other regulatory agencies; supervises subordinate staff; and performs other work as assigned. DISTINGUISHING CHARACTERISTICS: This single position classification is distinguished by its specialization in the management of all non-clinical provider activities within CCHP including ensuring that the community provider credentialing process meets all regulatorystandards and ensuring that the provider network meets access adequacy requirements. This class reports to the Deputy Executive Director, CCHP. MANAGEMENT RESPONSIBILITIES: • Directs provider contract planning and development as well as clinic and facility management agreements . • Oversees primary, ancillary,_and specialty care system adequacy arrangements • Formulates and recommends policies and procedures for the provider relations and, credentialing units • Provides direction and supervision to subordinate staff • Conducts studies to assess the adequacy of provider networks, ensure patient access and regulatory compliance, and improve administrative support and maximize services. • Consults with advisory boards and medical staff regarding administrative aspects of plan services • Represents the provider relations -functions to State and Federal agencies and is responsible for follow-up on contract compliance • Stays abreast of Federal and State legislation as it may relate to provider relations • Participates in policy-making discussions relative to future direction and administration of Health Plan provider networks Health Plan Director of Provider Relations and Credentialing Page 2 of 2 Prepares correspondence and reports. NIMUM QUALIFICATIONS: Education: Possession of a baccalaureate degree from an accredited college or university with a major in Business Administration, Public Administration, Hospital or Health Care Administration, Public Health Administration, or a closely related field. Experience: Three (3) years of full-time or its equivalent experience in an administrative capacity in either a health services agency or health plan or program, performing member and/or provider grievance management, developing member or provider communication media. At least one year of the required experience must have been in a supervisory capacity. Substitution: Possession of a Master's Degree in Business Administration, Public Administration, Hospital or Health Care Administration, Public Health Administration, or a closely related field may be substituted for one year of the required experience. No substitution is allowed for the required supervisory experience. KNOWLEDGE, SKILLS AND'ABILITIES: Knowledge of: ■ Principles and practices of health care administration ■ Laws and regulations governing pre-paid health plans and health maintenance organizations ■ Concepts of management and supervision Ability to: ■ Communicate effectively verbally and in writing ■ Provide leadership and direction to subordinates ■ Use office PC software programs proficiently Department Approval: Date: Human Resources Supervisor: Date. Human Resources Analyst: Date: Established: July 2007 Office of the Clerk of the Board of Supervisors CONTRA COSTA COUNTY 651 Pine Street, Room 106 Martinez, CA 94553 Phone: 925.335. 1900 Fax: 925.335. 1913 NOTICE OF CORRECTION TO RECORD Board Agenda Item No.: C.52 Date: July 24, 2007 Please note that the following correction was made to the record for this item: C.52 ADOPT Position Resolution No. 20301 to establish the classes of Health Plan Director of Provider Relations and Credentialing (unrepresented) and Health Plan Director of Contracting- (unrepresented), allocate them to the Salary Schedule, and add one position in each class in the Health Services Department. (Member premiums and reduction of contract expenses) (All Districts) PLEASE DESTROY 6 ANY PREVIOUS COPIES a 'x OF THIS RECORD AND REPLACE THEM a ." M. WITH THE ATTACHED APR ® 2 2007 POSITION ADJUSTMENT REQUEST NO. 3C7I 0FFICE..0F - COINITyggTOR ' DATE j 7'p f (IDIT0 EU Department No./ Department Health Services- CCHP All 1 Budget Unit No. 0860 Org No. 6106 Agency No.A-18 Action Requested `{ ESTABLISH THE CLASSIFICATIONS OF HEALTH PLAN DIRECTOR OF CONTRACTING -EXEMPT AND HEALTH PLAN DIRECTOR OF PROVIDER RELATIONS AND CREDENTIALING - EXEMPT Proposed Effective Date: 4/1/2007 Classification Questionnaire attached: Yes ❑ No ❑ Wftcost is within Department's budget: Yes ✓❑ No ❑ Total One-Time Costs (non-salary) associated with request: $ 0.00 Estimated total cost adjustment(salary/benefits/one time): Total annual cost $ 321,506.00 Net County Cost $ 0.00 Total this FY $ 80,376.00 N.C.C. this FY $ 0.00 SOURCE OF FUNDING TO OFFSET ADJUSTMENT Member premiums and the cancellation of contract positions.u,Q Department must initiate necessary adjustment and submit to CAO. Use additional sheet for further explanations or comments. 1 zw for Department Hea REVIEWED BY CAO AND RELEASED TO HU- . N RESOURCES DEPARTMENT. n-n Deputy County Administrator date HUMAN RESOURCES DEPARTMENT RECOMMENDATIONS i DATE OF 7 -Adep1 position.aadjustment Resalution_#-2939a--t6 ESTABLISH the classifications of Health Plan Director of ovif dec- � Relations and Credentialing4MW (VRG3) [unrepresented] and Health Plan Director of Contracting i(VRG2)- [unrepresented]: ALLOCATE both classifications to B85 1970 ($7366.88-$8954.49) of the salary schedule, and'AbD one position to each classification. 0 N Amend Resolution 71/17 establishing po itions and resolutions allocating classes to the Basic/Exempt salary schedule. Effective-. Day following Board Action. ///❑ (Date) for Director of Human Resource COUNTY ADMINISTRATOR RECOMMENDATION DATE "]//p/, e. Approve Recommendation of Director of Human Resources [] Disapprove Recommendation of Director of Human Resources ❑ Other: for CdLinty Administrator BOARD OF SUPERVISORS ACTION: John Cullen, Clerk of the Board of Supervisors Adjustmg►�t� APPROVED �� DISAPPROVED ❑ J and County Admini.trator DATE J .:..,Q 9. BY � C �. APPROVAL OF T IS ADJUSTMENT CONSTITUTES A PERSONNEL/SALARY RESOLUTION AMENDMENT POSITION ADJUSTMENT ACTION TO BE COMPLETED BY HUMAN RESOURCES DEPARTMENT FOLLOWING BOARD ACTION Adjust class(es)/position(s) as follows: P300(M347)Rev 3/15/01