Director, Behavioral Health

Job Number: 179609, Job Title: Director, Behavioral Health, Salary: $122,000.00 - $156,000.00 Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: Medicaid STAR, CHIP, Health Insurance Marketplace Plans, and Community Health Choice (HMO D-SNP). Community is accredited by URAC and offers care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System, Community is financially self-sufficient and receives no financial support from Harris Health or Harris County taxpayers. Overview Improving Members' experiences is at the heart of every Community position. We strive every day to ensure Members have access to high-quality health care they need and deserve. Job Summary The Director, Behavioral Health is accountable for the operational management of the Behavioral Health Team. Responsible for human resources, quality, and financial management of the program. The Director oversees implementation of case management and utilization functions, while serving as a clinical leader and resource for Behavioral Health. As a Director, Behavioral Health you will implement policies and procedures, while adhering to regulatory and non-regulatory standards. The role is responsible for evaluations and reports relevant to achievement of goals for the Utilization Management and Case Management teams. Provides oversight to ensure area staff utilization and engagement patterns are congruent to standards. Job Specifications and Core Competencies Department Management: Implement, monitor, and facilitate attainment of performance metrics to meet departmental expectations for productivity and quality. Manage staffing needs by reviewing analytic reports for productivity, pended cases, average admissions per facility, and complexity if facility needs. Conduct monthly audits of UM/CM teams and coordinators. Audits may be performed more frequently based on results or staff performance indicators. Coordinate clinical rounds and coach UM/CMs in preparing summaries and presenting cases. Works independently and takes initiative to improve UM/CM processes. Participate in work groups and committees, while overseeing clinical presentations to medical directors. Responsible for daily operations and ensuring staff assignments support workload. Ensure onboarding and orientation for all staff. Facilitate clinical rounds and recommend training. Oversee staff in the discharge planning needs of hospitalized members. Cross-functional Duties: Participate in Medical Affairs department programs, focus studies and all initiatives to improve health and quality of clinical care and service delivery to Community members and providers. Ensure turnaround time compliance is met with all UM/CM processes. Work with staff to mitigate and prevent non-compliance. Coordinate and monitor staff referrals to medical case management, high-risk perinatal, disease management, and quality improvement teams when appropriate. Actively contribute to achievement of departmental goals, as identified in the Department's annual business plan, including specific departmental process improvement plans and other duties as assigned. Reports to: SVP Medical Affairs. Employees Supervised: Behavioral Health Staff. Qualifications Education/Specialized Training/Licensure: Master's degree in social work or counseling required. Current unrestricted license in the state of Texas: LCSW, LMSW, LMFT or LPC required. Ten years of experience in case management and utilization management combined required. Management Experience (Years and Area): Seven years of experience managing cross-functional teams in a managed care environment required. Software Proficiencies: Advanced PC Skills, MS Word, MS Excel, MS Outlook. #J-18808-Ljbffr