The Health Services Department is requesting to add one Clerk-Specialist Level position to the Utilization Review (UR) Unit of the Behavioral Health Division. The Unit is responsible for the authorization and oversight of all mental health services provided by the Division and contract providers, and has recently added Alcohol and Other Drug (AOD) services under the Drug Medi-Cal Organized Delivery System Waiver. The Unit ensures that all required documentation for the services provided is met, appropriate, and acceptable within state and federal guidelines. Unit staff participates in internal and external audits and monitor for adequate, consistent and appropriate medical record documentation as it relates to medical necessity, utilization of resources, quality of care and discharge planning.  
Due to the implementation of two programs (Continuum of Care Reform and Drug Medi-Cal Organized Delivery System), additional staff support is required to address the increased workload. The Clerk-Specialist Level position will support these programs by: working in conjunction with program managers and supervisors to coordinate the utilization review process for mental health and AOD services; providing consultation and technical assistance on UR issues to supervisors, clinical and support staff; entering service authorizations and plan approvals into the system for tracking, authorization and submission for payment reimbursement to the County; posting and updating information in appropriate UR databases; screening UR documents submitted for authorization for completeness and errors; utilizing PSP report to direct and assist all providers with State documentation timeliness compliance; and researching and resolving billing issues.

Failure to approve this request will negatively impact the ability of the Behavioral Health Division to provide efficient services to the community.