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HomeMy WebLinkAboutMINUTES - 11181986 - 1.55 POSITION ADJUSTMENT REQUEST No: 7Q Date: 6/18/86 Dept. No./ - Copers Department Health Services/CCHP Budget Unit No. 0860 ; Org. No,. ii --AgencyNo. 54 Action Requested: Establish the class of Health Plan Provi:der,Affairs Manager - Exempt, alloca it to salary level #C5-2060 ($3563 - 4330) , and classify one ' "position.` Proposed Effective Date:i;:7_ . Explain why adjustment is needed: To provide an appropriate class and position to reflect the described activity. C1a�s-i ic-a i ieAAa a attached: Yes ® No Draft Spec. Estimated cost of adjustment: $ 349/mo. Cost is within department's budget: YesXQ No If not within budget, use reverse side to explain how costs are to be funded. Q Department must initiate necessary appropriation adjustment. Web Beadle, !/ Use additional sheets for further explanations or comments. Dppt. Persomel Officer or Department Head Personnel Department Recommendation - Date: 11/6/86 Establish the class of Health Plan Provider Affairs Manage r..- Exempt and allocate it to Salary Level C5 2118 (3775-4589) ; classify one position. This class is exempt from overtime. Amend Resolution 71/17 establishing positions and resolutions allocating classes to the Basic/Exempt salary Schedule, as described above. Effective: day foll win Bard action. �- Date for Director of Personnel County Administrator Recommendation Date: il�ldY'1 m4opopo�rove Recommendation of Director of Personnel c3 Disapprove Recommendation of Director of Personnel Other: for County Administrator Board of Supervisors Action NOV 18 1986 Phil Batchelor, CIPA of the Board of Adjustment APPROVED on Supervisors ndU-uety„dninistrator Date: NOV 18 1986 By: � APPROVAL OF THIS ADJUSTMENT CONSTITUTES A PERSONNEL/SALARY RESOLUTION AMENDMENT. M347 F/R9 - The principles and techniques of successfully operating a prepaid health plan; - Contemporary health policy issues; - Modern concepts of management and supervision. Ability to: - Gather and analyze data; - Analyze complex administrative problems and recommend effective solutions; - Negotiate contracts with various provider parties - Present cost consequences of alternative solutions to decision makers - Interpret and apply rules and regulations; - Supervise the work of others. Class Code: 10-7-86 LF:af cc: HDC, WPH, RKH, LF, SB, EK, JR Safety Health Services Departmental Approval j Date Director of Personnel J Date i EXEMPT D R A F T Proposed Salary Level Cb 2118 ($3775-4589) Contra Costa County October 1986 HEALTH PLAN PROVIDER AFFAIRS MANAGER DEFINITION: Under general direction, to plan, organize and direct the provider operations and related business affairs of the Contra Costa Health Plan; to advise the Executive Director and the Plan Advisory Board on operational , provider and policy matters; to coordinate operational and related business activities with the administrative staff of Merrithew Memorial Hospital and health centers; and to do related work as required. DISTINGUISHING CHARACTERISTICS: This single position class is exempt from the Merit System and is distinguished from other health care administrative positions by its specialization in the management of the non-medical operational activities of the Contra Costa Health Plan including developing, implementing and monitoring contracts with provider hospitals and other health care providers, and the ongoing operation of member service activities and utilization review systems of the Plan. It is distinguished from that of Marketing Director/CCHP - Exempt in that the latter 'directs the Plan's overall commercial and non-commercial marketing activities. This class reports to the Executive Director - Contra Costa Health Plan (Assistant Director of Health Services) . MANAGEMENT RESPONSIBILITIES: - Formulates and recommends operational and related business affairs policies and procedures and provides direction to the provider relations and related business units of the Health Plan; - Develops new product services and redesigns benefit package to increase Health Plan market share; j - Conducts special projects or studies designed to improve administrative support and maximize services, such as time studies of access to the delivery system; - Consults with the HMO Advisory Board and Plan medical staff regarding administrative aspects of Plan services; - Directs provider contract planning and development, clinic and facilities management agreements, membership services and grievance procedures, and the primary, ancillary and specialty care delivery system arrangements; - Develops, implements and monitors contracts with providers outside the County delivery system and interdivisional service agreements within the Health Services Department; - Keeps informed on Federal and State legislation as it may relate to the operation of HMO's; - Participates in policy making discussions relative to future direction and administration of the Health Plan; - Provides guidance on risk-sharing policies and incentives; - Coordinates visits by auditors from State and Federal agencies and is responsible for followup and contract compliance; - Works with management staff in the Department's Hospital and Clinics Division to insure Plan patients have adequate access to the delivery system and that services are acceptable to them; - Conducts meetings regarding Plan activities and responds to requests for information about the Contra Costa Health Plan; - Represents the Health'Plan as assigned with other Federal , State and other agencies; - Supervises the work of others; - Prepares correspondence and reports. DESIRABLE 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 years of fulltime experience or its equivalent in an administrative capacity in a health service agency or program, at least one year of which was in a health maintenance*organization or prepaid health plan. Substitution for Experience: Possession of a Master's Degree in one of the aforementioned subjects may be substituted for one year of the required general experience. Substitution for Academic Major: One year of additional qualifying experience may be substituted for the required academic major. Knowledge of: - The principles and practices of health care administration; - The laws and regulations governing prepaid health plans and health maintenance organizations; THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY , CALIFORNIA Adopted this Order on November 18 , 1986 by the following vote: AYES: Supervisor Fanden, Schroder, Torlakson, McPeak. NOES: None. ABSENT: Supervisor Powers . ABSTAIN: None. SUBJECTS Ordinance (s) Introduced The following ordinance(s) which amend(s ) the Ordinance Code of Contra Costa County as indicated having been introduced , the Board by unanimous vote of the members present waives full reading thereof and fixes December 2 , IgR6 as the time for adoption of same: Section 33-5 . 313 adds the Health Plan Provider Affairs Manager-Exempt to the list of classes and positions which are excluded from the County' s Merit System.