Associate Director (Behavioral Health Integration)

Associate Director (Behavioral Health Integration)

Job Description

Department(s): Behavioral Health Integration (BHI)
Reports to: Director, Behavioral Health Services
FLSA status: Exempt
Salary Grade: P – $117,000 – $165,000

Job Summary

The Associate Director of Behavioral Health Integration is responsible for the management of the behavioral health call center and care management functions. Under the guidance of the Director of Behavioral Health Services, the incumbent will oversee behavioral health clinical triage, care coordination, behavioral health treatment, and utilization management. The incumbent will provide coverage and support for the Director as needed. The incumbent, in support of the Director, will work with the Medical Director of Behavioral Health to establish clinical protocols for managing CalOptima members’ behavioral health needs. This is a leadership role that requires coordination with all levels of CalOptima staff, including Executives and Departmental Directors, Plan Members, Contracted Providers, Regulatory Affairs, and Legal Counsel, State and Federal Officials, and representatives of other agencies.

Position Responsibilities:

• Provides ongoing oversight and guidance to the BHI clinical staff on issues related to behavioral health services provided to members.
• Ensure the day-to-day clinical and BH Utilization Management (UM) activities are following regulatory requirements, accreditation standards and CalOptima policies.
• Collaborates with the Orange County Mental Health Plan and Drug Medi-Cal Organized Delivery System to ensure smooth transitions across the continuum of health care.
• Provides direction in assessing and addressing the dynamic and evolving behavioral health needs of CalOptima’s members.
• Serves as behavioral health clinical expert for internal departments, health networks, and contracted providers.
• Guides the clinical staff in the deployment of evidence-based behavioral health projects and/or initiatives to ensure person-centered care, seamless services integration, and continuous improvement that will assist the agency in achieving maximum health outcomes and improve cost.
• Partners with the Medical Director of Behavioral Health to support care coordination, care transition, and utilization review activities.
• Ensure that policies and procedures necessary to operate the department and comply with regulatory and accreditation requirements are in place and updated no less than annually.
• Work with Director on Behavioral Health quality initiatives and programs.
• Assists the Director of Behavioral Health Services in all areas of the department, as requested, to ensure department and organizational goals are met.
• Supports Director in the development and monitoring of departmental budget.
• Other projects and duties as assigned.

Possess the Ability To:

• Analyze complex issues, develop alternative solutions, and present clear alternatives and recommendations.
• Work in a dynamic environment with both short-term and long-term deadlines.
• Prepare concise and clear documentation, including policies and procedures, project management, and teaching materials.
• Identify pertinent policy and programmatic issues; develop strategies, solutions, and recommendations.
• Establish and maintain effective interpersonal relationships with all levels of staff, other programs, agencies, members, providers, and the public.
• Communicate effectively, both verbally and in writing, with individuals from diverse backgrounds.
• Manage a diverse staff, numerous simultaneous projects, and their respective activities, timelines, and issues.
• Motivate and lead team members and staff at all levels in the organization.
• Ensure the ongoing professional performance and development of subordinate staff to support CalOptima’s strategic direction and population health needs of the community.
• Work under the pressure of strict deadlines on multiple projects in a fast-paced environment.

Experience & Education:

• Master’s degree in behavioral health is required.
• Possess one (1) of the following licensures: Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), or Licensed Psychologist is required.
• 5 years of experience providing behavioral health services for diverse populations is required.
• 4 years of management/supervisory experience in behavioral health services administration is required.

Preferred Qualifications:

• 4 years of HMO, Medi-Cal/Medicaid, Medicare, and insurance experience and/or relevant government client/public service experience is strongly preferred.
• Experience with behavioral health regulations and the provider accreditation process is preferred.

Knowledge of:

• The culture and needs of the diverse population CalOptima serves.
• Community-based organizations, agencies, and community services.
• Orange County’s behavioral health system of care and stakeholders.
• Principles and practices of health care, health care systems, and managed care.
• Knowledge of behavioral health utilization management.
• Federal and State legislative and administrative processes, public policies, and applicable legal provisions to managing a public entity and health care management agency.
• Principles and techniques of effective administration and supervision, including training and evaluation.
• Medi-Cal and Medicare benefits and regulations.
• Techniques of program and policy development, administration, and coordination.

CalOptima is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima wants to have qualified employees in every job position. CalOptima prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

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Job Location: Orange, California

Position Type:

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