RECOMMENDATION(S):

Adopt Position Adjustment Resolution No. 21215 to add two (2) Health Plan Authorization Representative (VRTA) positions, at salary level 3RX 1119 ($3227.16 - $4121.22), in the Health Services Department.

FISCAL IMPACT:

Upon approval, this action will result in an annual cost of approximately $126,988.20, including pension costs of $27,495.40, and will be funded with Contra Costa Health Plan member premiums and the elimination of two temporary employees.

BACKGROUND:

Due to the increase in referrals and authorizations from health plan members and providers, Contra Costa Health Plan’s Utilization Management and Authorization Unit needs two permanent Health Plan Authorization Representative positions to process these requests timely. These positions will be responsible for obtaining all necessary documentation required to process requests for medical services or prescription drugs not found on the health plan drug formulary; preparing correspondence and maintaining documents related to authorizations, denials and appeals; and assisting members and providers in understanding the authorization and appeal processes.