HomeMy WebLinkAboutMINUTES - 03312015 - C.53RECOMMENDATION(S):
ADOPT Position Adjustment Resolution No. 21638 to add two (2) permanent full-time Registered
Nurse-Experienced Level (VWXD)positions ($7,305-$8,142)in the Contra Costa Health Plan division of the Health
Services Department.
FISCAL IMPACT:
The additional costs associated with this action will be $300,407 annually with benefits, including pension costs of
approximately $69,375. The costs will be offset by CCHP Enterprise Fund III (100%).
BACKGROUND:
Due to growth in membership over the past year (60,000 new members) and large influx of claim reviews/appeals,
we are in need of additional nurses to support the mandated turnaround timeframes of the Utilization Management
unit. The Utilization Management nurse uses a multi-disciplinary approach to organize, coordinate, monitor, evaluate
and modify plans of care and/or service requests focusing on selected complex medical and psychosocial needs of
CCHP members and their families. The UM Nurse is responsible for assuring the receipt of high quality, cost efficient
medical outcomes for enrollees. This role works with Medical Directors to perform first level review. To pre-certify
elective services, procedures and test utilizing established Care Coordination policies and protocols, CCHP benefit
criteria, applicable regulatory review criteria and nationally accepted criteria for medical necessity determination.
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
Action of Board On: 03/31/2015 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:Candace Andersen, District II
Supervisor
Mary N. Piepho, District III
Supervisor
Karen Mitchoff, District IV
Supervisor
ABSENT:John Gioia, District I Supervisor
Federal D. Glover, District V
Supervisor
Contact: Kristen Cunningham,
925-957-5267
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the
Board of Supervisors on the date shown.
ATTESTED: March 31, 2015
David Twa, County Administrator and Clerk of the Board of Supervisors
By: Chris Heck, Deputy
cc:
C. 53
To:Board of Supervisors
From:William Walker, M.D., Health Services
Date:March 31, 2015
Contra
Costa
County
Subject:Add two Registered Nurse-Experienced Level positions in the Health Services Department
CONSEQUENCE OF NEGATIVE ACTION:
If this action is not approved and without additional staff, Contra Costa Health Plan's Utilization Management
unit will not be able to meet the mandated requirements of the Plan.
CHILDREN'S IMPACT STATEMENT:
N/A
ATTACHMENTS
P-300 #21638