CAMHD Program Monitor (PREA)

Apr 01 2020
Job Description

 

State of Hawaii

Department of Health

Child and Adolescent Mental Health Division

Program Improvement & Communication Office

Manoa – Kahala, Oahu


Child and Adolescent Mental Health Division (CAMHD) Program Monitor (PREA)

$45,576 - $57,720 Annually, salary commensurate w/ training and experience

 

Exempt, Non-Civil Service Appointment.  The primary purpose of this position is to provide monitoring and technical support for contracted provider agencies and the CAMHD Family Guidance Center (FGCs) to review and assess the quality of services provided.  The purpose of the review is to assure high quality care, effective and efficient delivery of services through the examination of practices in order to achieve outcomes for youth served.

 

The primary function of the Health Systems Management Office (HSMO) is to provide understanding and knowledge of healthcare billing practices, reforms and Medicaid to the CAMHD staff; to ensure operations and business practices are developed, coordinated, structured, and maintained in alignment with federal, HIPAA, and state health records, billing, and credentialing standards and compliance requirements; to develop, coordinate, and monitor quality assurance; and to ensure information technology system operations, planning, and strategy for maximization of ongoing and alternative sources of funding. 

 

The subject position reviews, audits, and ensures timely processing of CAMHD contracted providers’ billing and claims, and to ensure they are in compliance with federal and state laws including federal healthcare regulations, MedQUEST insurance standards, and CAMHD contract requirements and performance management standards.

 

 

Minimum Qualifications

 

EDUCATION:  Possession of a bachelor’s degree in healthcare, business, finance, accounting, or a related field from an accredited college or University required.  Master’s Degree in healthcare, business, finance, accounting, or related field preferred. 

 

EXPERIENCE:  Experience in auditing, billing and claims operations in healthcare; experience in utilization management in retrospective and concurrent reviews; experience operating in a regulated environment involving compliance of federal, state, and local laws and regulations, and/or corporate policies and procedures.

 

2 ½ years of progressively responsible work experience in conducting and analyzing performance reviews including case-based reviews.  Experience must also have included extensive report writing and other methods of presenting findings and data.  1-year professional experience involved in children and adolescent’s mental health care.

 

LICENSE:  Valid Hawaii Driver’s License Preferred.  Certifications and/or accreditations in claims reviews, medical and billing record management, medical and billing record auditing, healthcare fraud investigations, project management, and claims coding also preferred.

 

Who May Apply

 

LEGAL AUTHORIZATION TO WORK REQUIREMENT:  The State of Hawaii requires that all persons seeking employment with the government of the State shall be citizens, nationals, or permanent resident aliens of the United States, or eligible under federal law for unrestricted employment in the United States.

 

How to Apply

 

Submit completed State of Hawaii Application for Non-Civil Service Appointment, cover letter, resume, (3) references, PREA Questionnaire, and salary requirements to:

 

Department of Health

Human Resources Office – Recruitment & Examination

1250 Punchbowl Street, Room 122

Honolulu, Hawaii  96813

 

Application packet:  http://health.hawaii.gov/emplo​yment/job-opportunities/

 

Other Information

 

For additional information, please call CAMHD Personnel at (808) 733-8371.

 

Recruitment is continuous until needs are met.

 

This position is exempt from the civil service.  Employment in such positions is considered to be “at will.”

 

Prison Rape Elimination Act (PREA) Requirement:  As required by the Prison Rape Elimination Act of 2003 (PREA), Federal law states that “….an agency shall not hire or promote anyone who may have contact with inmates and who: 

(1)  Has engaged in sexual abuse in a prison, jail, lockup, community confinement facility, juvenile facility or other institution.

(2)  Has been convicted of engaging or attempting to engage in sexual activity in the community facilitated by force, overt or implied threats of force, or coercion, or if the victim did not consent or was unable to consent or refuse.

(3)  Has been civilly or administratively adjudicated to have engaged in the activity described in #2 above.

(4)  Has been the subject of substantiated allegations of sexual harassment or resigned during a pending investigation of alleged sexual abuse or sexual harassment.


An Equal Opportunity Employer