Health Choices Project Manager

County of Berks, PA; Reading (Berks County); On-site; USD 85,000 - 125,000; Full time

Job summary

County of Berks, PA seeks a Project Manager to develop and oversee Behavioral Health HealthChoices projects in Berks County for Medicaid recipients, including oversight of BH-MCO's Compliance Program.

The role requires a Master’s in social or human services, 5+ years of behavioral health PM experience, and skills in budgeting, data analysis, and communication. Travel within the county/state may be required to support program goals.

Qualifications

• Master's degree required in social or human services.
• At least five years of direct clinical behavioral health experience, including project management.
• Valid Pennsylvania driver's license with good driving record.
• Knowledge of budget development and analysis.
• Ability to communicate effectively with professionals and members.

Responsibilities

• Serve as project lead and ensure DHS project compliance (e.g., Value Based Purchasing).
• Collaborate with BH-MCO on strategic planning and assigned projects.
• Oversee BH-MCO's Compliance/FWA program and reporting.
• Review BH-MCO initiatives, policies, and performance standards.
• Manage Berks behavioral health provider network and service expansion reviews.
• Develop and monitor reinvestment plans with budgets and reporting.
• Participate in member-specific cases to ensure medically necessary services.
• Complete Emergency Behavioral Health certification and mandatory training.
• May assist as Emergency Services Delegate on a 7-day rotation if needed.

Skills

Behavioral Health Systems

Project Management

Data Analysis

Budget Analysis

Communication

Independent Work

Education

Master's degree in social or human services

Tools

MS Office

Job description

The Project Manager is responsible for the development and maintenance of projects in the Berks County Behavioral Health HealthChoices Program for Medicaid recipients, including providing oversight of the sub-contracted Behavioral Health Managed Care Organization's (BH-MCO) Compliance Program.

The Project Manager is responsible for the development and maintenance of projects in the Berks County Behavioral Health HealthChoices Program for Medicaid recipients, including providing oversight of the sub-contracted Behavioral Health Managed Care Organization's (BH-MCO) Compliance Program.

Position Responsibilities

***Essential Functions***

The duties and responsibilities of this position include, but are not necessarily limited to:

• Serve as project lead and ensure compliance for assigned Department of Human Services (DHS) projects, such as Value Based Purchasing (VBP).
• Serve as project lead and collaborate with the BH-MCO on strategic planning and assigned projects.
• Oversee the BH-MCO’s Compliance/Fraud, Waste and Abuse (FWA) Program to ensure compliance with state and federal requirements, including timely and accurate reporting, work plan monitoring, and collaborating on provider audits, findings, and related interventions.
• Review the BH-MCO’s initiatives, policies/procedures, performance standards, and related documents.
• Manage the Berks behavioral health provider network to ensure access standards and service needs are met, including review and approval of service descriptions and expansion requests, data and trend analysis to identify service gaps, and program development.
• Develop and monitor reinvestment plans to enhance behavioral health services, including budgets, outcomes, and required reporting.
• Participate in member-specific cases to ensure medically necessary behavioral health services are provided.
• Serve as project lead on departmental assignments.
• Complete Emergency Behavioral Health certification as well as mandatory training and clearances.
• If the incumbent is approved by the State of PA to act as an Emergency Services Delegate, then they may be required to assist in providing coverage to perform duties of an Emergency Services Delegate if needed. May be required to assist on a 7-day, 24-hour rotation program.

Minimum Education And Experience

• Master's degree in social or human services.
• At least five years of direct clinical experience in a behavioral health setting, to include behavioral healthcare project management.
• Equivalent combinations of experience and training may be considered.
• Valid Pennsylvania driver's license with good driving record.

Minimum Knowledge, Skills And Abilities

• Knowledge of the behavioral health system.
• Knowledge of behavioral health project management, including data collection and analysis.
• Knowledge of budget development and analysis.
• Ability to establish and maintain positive working relationships.
• Ability to communicate effectively and diplomatically with professionals and members, both orally and in writing.
• Ability to manage multiple priorities in an organized, detail-oriented, and efficient manner.
• Ability to work independently with minimal supervision.
• Proficiency with standard computer software programs.
• Ability to handle stress.
• Physical presence in the office required.

Physical Demands

Work involves standing, walking, sitting, lifting, carrying, talking, hearing, using hands to handle, feel objects, tools, or controls, and reaching with hands and arms. Vision abilities required by this job include close vision and the ability to adjust focus. The employee must occasionally lift and/or move up to 25 pounds.

Working Environment

Normal cubicles and individual office environment. Work is primarily performed during regular business hours; however, occasional evening or weekend work may be required based on the department's needs. Position requires occasional travel within the county and state to perform job functions. The position may require working in moderately noisy to loud environments, including cubicles and communal workspaces, and participating in frequent collabo ative team meetings. The work environment may include a fast-paced setting with frequent interruptions, changing priorities, and interactions with employees, the public, and other stakeholders. *This position description serves as a guideline for communicating the essential functions and other information about the position to the applicant/employee. It is not intended to create a binding employment contract nor cover every detail of the position and may be changed where appropriate.*