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Health Services Coordinator at San Andreas Regional Center – San Jose, California

San Andreas Regional Center
San Jose, California, 95119, United States
Posted on
NewJob Function:Medical
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About This Position

Description:

Join San Andreas Regional Center – Where Every Role Matters.

San Andreas Regional Center (SARC) is one of 21 regional centers in California, funded by the State and rooted in the values of the Lanterman Act. As a community-based nonprofit, we are dedicated to supporting individuals with developmental disabilities in living full, independent, and inclusive lives.

Join a diverse, mission-driven team that is passionate about making a meaningful difference every day. If you care deeply about equity, advocacy, and social impact— SARC is the place for you.

Job Summary:

This position maintains the vision and mission of the Health Services Unit by providing health advocacy for individuals served by San Andreas Regional Center (SARC). The role requires a close working relationship with SARC District Managers; hospital case management teams; County Managed Care Plans; Community Living Section RNs; nurse consultants at the Department of Developmental Services (DDS); and local licensing agencies, including the California Department of Social Services (CDSS) and the California Department of Public Health (CDPH). Clear communication, education regarding the Developmental Disabilities Services System, and effective information-sharing are essential to forming and maintaining these relationships. The position requires knowledge of how health issues impact individuals with developmental disabilities.

Pertinent clinical updates related to individuals served, as well as significant activities of the Health Services Unit, will be reported regularly to SARC’s Executive Team. This position manages a team of health professionals, including Registered Nurses (RNs), a Registered Dental Hygienist in Alternative Practice (RDHAP), and an Occupational Therapist (OT), to consult, educate, advocate, and promote quality care in collaboration with the Interdisciplinary Planning Team. The position serves as the coordinator of the agency’s Bioethics Committee and acts as the Executive Director’s designee when he or she is unavailable to provide consent for treatment.

Ensures ongoing collaboration with Medi-Cal Managed Care Plans in the four counties served by SARC and understands the healthcare system’s obligation to provide durable medical equipment (DME) and services required to optimize healthy living.

Works with specialty providers such as DME companies, specialty dentists, and Adult Residential Facilities for Persons with Special Health Needs (ARFPSHN) agency directors to ensure and monitor quality of care. The role has the autonomy to determine medical necessity and identify alternative resources for medical expenses for which the Regional Center may become responsible. The position requires knowledge of standards of care and scope of practice for health professionals working with individuals with developmental disabilities.

Essential Job Functions:

The Health Services Manager must be familiar with the medical scope of care and service needs of individuals with developmental disabilities and manage a team of health professionals who provide clinical consultation to Service Coordinators and Managers. The position interfaces with all departments within San Andreas Regional Center, local hospitals, and health professionals, including dentists; the Department of Developmental Services (specifically those associated with ARFPSHN behavioral homes and ICF residences); community care providers; and county services, including but not limited to Medi-Cal Managed Care Plans and California Children’s Services.

Work closely with the San Andreas Intake Department and Early Start team to assist with evaluations for individuals with medical conditions related to Lanterman eligibility, specifically epilepsy and cerebral palsy. The ultimate goal of this position is to coordinate appropriate, high-quality care advocacy for individuals served by SARC.

Develop and maintain expertise in health benefits to support the Memorandum of Understanding (MOU) between the Medi-Cal Managed Care Plans and San Andreas Regional Center. The role serves as the primary contact for all four Medi-Cal Managed Care Plans and their network providers, assisting in identifying and resolving day-to-day operational issues. The position is expected to train healthcare providers and insurance liaisons regarding developmental disabilities, advocate for services and supports, and make every effort to resolve access-to-care and care-coordination issues.

Interface with physicians, specialists, families, clients’ rights advocates, and staff when a Bioethics Committee meeting is requested and serves as the lead facilitator of the committee. The role must understand the philosophy of the Executive Director when acting as designee for consent to treatment and when assisting with POLST. The position requires knowledge and expertise in medical standards of care and compassionate end-of-life considerations. The role also supports monthly report writing for the Mortality and Morbidity Committee.

Must be proficient in regulations governing all types of residential care homes to advise on quality-of-care issues. The Health Services Manager ensures that Health Services Unit clinical staff are trained in regulations impacting Lanterman eligibility and provisional eligibility, level-of-placement assessments, and respite assessments needed to support Service Coordinators. The position supervises the development of training provided by the Health Services Educator, ensuring it is regulation- and standards-of-practice-based and offered to clinical staff, service providers, Regional Center employees, and others as appropriate.

Oversees specialty dental contracts to ensure dental services are targeted to individuals’ specific needs and works to ensure general dentistry services are available throughout the SARC catchment area.

Tracks hospitalizations, evaluates trends, identifies clinical training needs for caregivers, and collaborates with the Quality Standards and Compliance Coordinator. Health Services clinical staff are assigned to follow up on health issues impacting individuals served. The role includes reporting successes and challenges in ensuring quality care to the Quality Assurance and Advisory Committee, a subcommittee of the Board of Directors.

As mandated by the Welfare and Institutions Code for ARFPSHN homes, the Health Services Coordinator ensures that the unit RN performs Quality Monitoring Visits as outlined in the Code.

Participate in creative resource development, including leading interdisciplinary teams, engaging in community outreach, and participating in community health collaborative efforts to expand options and enhance the quality of health services accessible to consumers.

Other duties as assigned.

SUPERVISION EXERCISED:

Health Services Unit

We offer a competitive benefits package designed to support your health, well-being, and future.

Employees receive free medical coverage (yes, free for employees!), along with free dental and vision insurance for your dependents.

Our benefits include a CalPERS pension plan, offering rare, long-term financial security through a lifetime pension, excellent health benefits, and overall career stability. Additional benefits include a 403(b) retirement plan, flexible spending accounts, and an Employee Assistance Program (EAP).

You'll also enjoy:

  • Five days of paid education leave per fiscal year
  • Vacation time, sick leave, 12 paid holidays and 2 floating holidays!
  • Life insurance, with options for additional coverage
  • Access to an employee discounts portal full of great deals
  • We offer flexible work schedules and select hybrid positions, promoting a healthy and balanced work-life experience. And that’s just the beginning — explore the full list of benefits on our careers website! (**Benefits apply to eligible employees.)
Requirements:

Education/Experience:

Must possess a clinical license (RN preferred) with a bachelor’s or master’s degree in nursing or a related field. Requires experience supervising health professionals in a clinical setting or related management experience. Preferably two years of experience working with individuals with intellectual and developmental disabilities. Familiarity with Health Plans and HMOs and the ability to mediate between opposing entities for the benefit of the consumer are required. Excellent communication, writing, critical thinking, and ethical decision-making skills are essential.

Special Skills and Knowledge:

Proficiency in PowerPoint, Excel, and Word is required. This position is administrative and confidential in nature. Must have knowledge of standards of care and scope of practice for health professionals working with individuals with developmental disabilities. Must understand general Medi-Cal and Medicare benefits, services, and funding mechanisms for various residential facility types under San Andreas Regional Center.

Other:

  • Ability to support the on-call manager during evenings and weekends as needed.
  • Expected to attend four Board of Directors meetings per year.
  • Expected to attend some SARC community outreach activities outside regular working hours.
  • Remote work is at the discretion of the Director of Consumer Services.
  • Use of an automobile, possession of a valid driver’s license, and automobile liability insurance in the minimum amount prescribed by law, or the ability to provide independent transportation.

Job Location

San Jose, California, 95119, United States
Loading interactive map for San Jose, California, 95119, United States

Job Location

This job is located in the San Jose, California, 95119, United States region.

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