Service Authorization Consultant

2 weeks ago

Richmond, United States Dept Behavioral HealthDevelop Full time

**Title**: Service Authorization Consultant

**State Role Title**: Health Care Compliance Spec II

**Hiring Range**: Up to $65,000

**Pay Band**: 5

**Agency**: Dept Behavioral Health/Develop

**Location**:Central Office

**Recruitment Type**: General Public - G

**Job Duties**
- The Department of Behavioral Health and Developmental Services (DBHDS) is seeking a highly motivated individual to ensure that the DBHDS Developmental Disabilities waivers’ service authorization system maintains all standards of accountability, proficiency, and responsiveness to the users of the system which results in the alignment of needs and resources of all the individual’s receiving waiver funded services. Incumbent will be responsible for the review of Individual Support Plans, Planning Calendars, and Service Authorizations for the waivers for individuals with developmental disabilities, assuring that all criteria are met from when the process initiates with the case manager/support coordinator through to the authorization of a service. This includes, but is not limited to, discussing appropriate service alternatives with support coordinators/case managers and their supervisors to include the provision of needed training and technical assistance; problem solving to ensure individuals receive the appropriate services according to their assessed needs; and communicating the results of the review process to CSBs, private providers and the VA Medicaid Enterprise System (MES). This position serves several Northern Virginia counties and cities such as: Alexandria, Arlington, Fairfax-Falls Church, Loudoun, & Prince William County. This is a full-time telework position, with frequent state travel, as this position will be training community partners on SA Best Practice and WaMS navigation.
Additional responsibilities include:

- Performing clinical review and/or authorization of waiver and EPSDT services for individuals with developmental disabilities for all new and revised service plans, as appropriate.
- Utilizing knowledge of authorization procedures and interpretation of Medicaid regulations, policies, and procedures.
- Accurately entering service authorization information into the Waiver Management System/Virginia Medicaid Management Information System (VAMMIS).
- Providing service authorization related consultation and training to assigned Community Services Boards/private providers of case management services.
- Analyzing trends and problem areas within localities; providing recommendations and assistance to other DDS staff regarding technical support, training, and the development of guidance materials.
- Abiding by all legal and regulatory standards promulgated by state, federal and professional regulatory organizations and will engage in conduct that is professional and ethical at all times, to the best of my knowledge and understanding.

**Minimum Qualifications**
- Knowledge of professional standards of supports and services for individuals with developmental disabilities (DD), including knowledge of best practices.
- Knowledge of the health care needs of persons with disabilities (physical, cognitive, emotional), health and social service programs and issues, community resources, state and federal DD regulations, negotiation techniques, problem resolution, medical terminology, and medical standards of treatment.
- Ability to work with electronic information systems.
- Demonstrated ability to organize and prioritize work assignments, and to communicate effectively orally and in writing.
- Ability to research and identify changes in program requirements and policies and to interpret state and federal regulations.

**Additional Considerations**
- Experience in social, behavioral science, education, or related human services field.
- Understanding of best practices in developmental disability (DD) services or understanding of how best practices are adopted and ability to translate experiences and training within the DD system.

**Special Instructions**

This position is eligible for telework opportunities; availability, hours, and duration of telework shall be approved as outlined in the Commonwealth telework policy.

DBHDS welcomes all applicants authorized to work in the U.S. For more information on how to seek this authorization, please refer to Working in the United States or contact the U.S. Citizenship and Immigration Services office directly.

**Contact Information**

Name: Keiana Bobbitt

Phone: N/A

Note**: Applicants who received a Certificate of Disability from DARS or DBVI dated between April 1, 2022- February 29, 2024, can still use that COD as applicable documentation for the Alternative Hiring Process.

Each agency within the Commonwealth of Virginia is dedicated to recruiting, supporting, and maintaining a competent and diverse work force. **Equal Opportunity Employer

  • Service Authorization Consultant

    2 weeks ago

    Richmond, United States Dept Behavioral HealthDevelop Full time

    **Title**: Service Authorization Consultant **State Role Title**: Health Care Compliance Spec II **Hiring Range**: $50,000-$60,000 **Pay Band**: 5 **Agency**: Dept Behavioral Health/Develop **Location**:Central Office **Recruitment Type**: General Public - G **Job Duties** Additional responsibilities include: - Performing clinical review and/or...

  • Service Authorization Consultant

    4 weeks ago

    Richmond, United States Commonwealth of Virginia Full time

    Job Duties The Department of Behavioral Health and Developmental Services (DBHDS) is seeking a highly motivated individual to ensure that the DBHDS Developmental Disabilities waivers’ service authorization system maintains all standards of accountability, proficiency, and responsiveness to the users of the system which results in the alignment of needs...

  • Service Authorization Consultant

    4 weeks ago

    Richmond, United States Commonwealth of Virginia Full time

    Job Duties The Department of Behavioral Health and Developmental Services (DBHDS) is seeking a highly motivated individual to ensure that the DBHDS Developmental Disabilities waivers’ service authorization system maintains all standards of accountability, proficiency and responsiveness to the users of the system which results in the alignment of needs...

  • Authorization/Billing Specialist

    4 weeks ago

    Richmond, United States U.S. Physical Therapy Full time

    Overview Clinic Name: Physical Therapy Solutions Position: Authorization/Billing Specialist Location: Richmond, VA Employment Type: Part or Full-Time Over the last ten years, Physical Therapy Solutions has served the greater Richmond area's Physical Therapy needs, focusing on putting our patient's needs first. With three locations, Richmond, Glen Allen,...

  • Insurance Authorization Specialist

    3 weeks ago

    Richmond, United States Ensemble Health Partners Full time

    **Thank you for considering a career at Ensemble Health Partners!** Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients...

  • Authorization/Billing Specialist

    2 weeks ago

    Richmond, Virginia, United States U.S. Physical Therapy Full time

    OverviewClinic Name: Physical Therapy SolutionsPosition: Authorization/Billing SpecialistLocation: Richmond, VAEmployment Type: Part or Full-TimeOver the last ten years, Physical Therapy Solutions has served the greater Richmond area's Physical Therapy needs, focusing on putting our patient's needs first. With three locations, Richmond, Glen Allen, and...

  • Consult Coordinator

    2 weeks ago

    Richmond, Virginia, United States Virginia Cancer Institute Full time

    Job DescriptionJob DescriptionWe support a professional and encouraging workplace with a Monday-Friday daytime schedule Join the premier cancer treatment center on the East Coast- Virginia Cancer Institute, a well-respected, growing medical practice in Richmond, Virginia is looking for a self-motivated Consult Coordinator to work with our friendly and...

  • Customer Service Consultant

    2 months ago

    Richmond, United States Caliber Collision Repair Services Full time

    Caliber Collision has an immediate job opening for a Customer Service Consultant to perform all-purpose duties, which may include, but not limited to properly greeting customers in person or on the phone, determine their needs, and immediately respon Customer Service, Consultant, Service, Retail, Automotive, Customer

  • Authorization Technician

    2 months ago

    Richmond, United States Richmond Behavioral Health Authority Full time

    The** Richmond Behavioral Health Authority **is seeking a **PRN Authorization Technician** to join our** Quality **team! Prior authorization_ _is a process used by many health insurance companies to determine whether they will reimburse a prescribed procedure, service, or medication. Work is performed under the limited supervision of the Health Care Data...

  • Authorization Technician

    4 weeks ago

    Richmond, United States Richmond Behavioral Health Authority Full time

    Description The Richmond Behavioral Health Authority is seeking a PRN Authorization Technician to join our Quality team! Prior authorization is a process used by many health insurance companies to determine whether they will reimburse a prescribed procedure, service, or medication. Work is performed under the limited supervision of the Health Care Data...

  • Authorization Technician

    4 weeks ago

    Richmond, United States Richmond Behavioral Health Authority Full time

    Description The Richmond Behavioral Health Authority is seeking a PRN Authorization Technician to join our Quality team! Prior authorization is a process used by many health insurance companies to determine whether they will reimburse a prescribed procedure, service, or medication. Work is performed under the limited supervision of the Health Care Data...

  • Pharmacy Prior Authorization Coordinator I

    2 weeks ago

    Richmond, United States Sentara Healthcare Full time

    **Sentara Health** is currently recruiting for a **Full-Time, Remote** **Pharmacy Prior Authorization Coordinator I in Richmond or Tidewater, VA area**. Under the direct supervision of a Pharmacy Team Coordinator, the pharmacy prior authorization coordinator (PAC) is responsible for supporting the Pharmacy Department's day-to-day operations for the call...

  • Functional Consultant

    4 weeks ago

    Richmond, United States Tata Consultancy Service Limited Full time

    Job Title SAP SAP Plant MaintenanceMust Have Technical/Functional Skills Require deep knowledge of utility business processes; excellent communication skills, minimum 10 years of experience in SAP Plant Maintenance, Asset Management and integration with other EAM applications required with proven track record of successful SAP ERP/EAM implementations.SAP...

  • Pharmacy Prior Authorization Coordinator I

    2 weeks ago

    Richmond, Virginia, United States Sentara Healthcare Full time

    Sentara Health is currently recruiting for a Full-Time, RemotePharmacy Prior Authorization Coordinator I in Richmond or Tidewater, VA area.Under the direct supervision of a Pharmacy Team Coordinator, the pharmacy prior authorization coordinator (PAC) is responsible for supporting the Pharmacy Department's day-to-day operations for the call center and prior...

  • Wireless Retail Sales Consultant

    4 weeks ago

    Richmond, United States Cellular World-AT&T Authorized Retailer Full time

    **AT&T Bilingual Wireless Retail Sales Consultant** Cellular World | AT&T Authorized Retailer **$35,000 - $55,000** yearly including base pay, commissions, and bonuses **Cellular World**, an AT&T Authorized Retailer with over 125 locations and growing, has immediate opportunities for fun, passionate, and dedicated individuals on our **AT&T Bilingual...

  • consultant, sales and service

    4 weeks ago

    Richmond, Virginia, United States teamworkonline Full time

    CONSULTANT, SALES AND SERVICE (UNIVERSITY OF RICHMOND)Richmond, VAOn Site THE RUNDOWN Playfly Sports is looking for a Consultant, Sales and Service to join our team in Richmond, VA. Consultants act as the primary liaison between our current client base and Collegiate Athletics Department, are responsible for renewing and growing all season ticket accounts...

  • Senior Consultant

    4 weeks ago

    Richmond, United States Lynch Consultants Full time

    What We Are LookingFor: We are seeking an experienced manager with 4-6 years experience in financial statement audit, internal controls/OMB A-123, or audit sustainment and remediation services for a US Department of Defense (DoD) Agency. Must possess excellent analytical skills, technical ability, and client-facing experience delivering high-level...

  • Health Insurance Authorization Representative

    3 days ago

    Richmond, United States Parallon Full time

    Description Introduction Do you have the career opportunities as a Health Insurance Authorization Representative you want with your current employer? We have an exciting opportunity for you to join Parallon which is part of the nation's leading provider of healthcare services, HCA Healthcare. Benefits Parallon, offers a total rewards package that supports...

  • Senior Consultant, Professional Services

    1 week ago

    Richmond, United States Lucid Software Full time

    Senior Consultant, Professional Services at Lucid Software Remote, US Lucid Software is the leader in visual collaboration, helping teams see and build the future from idea to reality. We hold true to our core values: innovation in everything we do, passion & excellence in every area, individual empowerment, initiative and ownership, and teamwork over ego....

  • Health Insurance Authorization Representative

    4 weeks ago

    Richmond, United States Parallon Full time

    Description Introduction Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Health Insurance Authorization Representative opening with Parallon today and find out what it truly means to be a part of the HCA Healthcare team. Benefits Parallon, offers a total rewards package that supports the health,...