Behavioral Health Clinical Operations Manager

The Behavioral Health Clinical Operations Manager is responsible for the overall coordination and management of BMCHP’s Behavioral Health (BH) management processes and functions, including but not limited to hospital coordination, prior-authorization processes, after hours authorization, utilization and care management operations. Collaborates in the development and implementation of strategies to meet all BMCHP’s behavioral health quality goals. In conjunction with BH leadership and Public Partnerships, communicates member, program performance and operational detail to the Massachusetts Executive Office of Health and Human Services (EOHHS) and other stakeholders as appropriate.

Key Functions/Responsibilities:

– Leads the development and implementation of clinical operations initiatives including policies and procedures, care coordination, workflow plans, intensive clinical management, utilization review, and other clinical areas.
– Works collaboratively with clinical and medical staff on clinical program development, clinical guidelines and evidence-based practices in behavioral health.
– Collaborates with other department managers in the planning, development and coordination of department specific and cross-functional initiatives.
– Ensures Behavioral Health has up-to-date clinical performance specifications and information is documented and communicated to staff via written operational policies, procedures and related workflows
– Works collaboratively with BH medical staff on clinical program issues.
– Works collaboratively with medical care management and utilization management senior leadership, other internal departments and providers to ensure the integration of BH and other programs and services.
– Along with BH leadership, coordinates information to EOHHS, other state regulators and stakeholders as appropriate to demonstrate program performance and meeting member needs.
– Participates and works with BH senior leadership as appropriate in the recruitment, orientation, management, supervision and training of staff.
– Assists senior behavioral health management staff in ensuring the success of clinical network quality improvement initiatives.
– Provides high level of service and satisfaction to internal and external customers
– Attendance is an essential function of the position.
– Perform other duties as assigned

Qualifications:

Education:
– Master’s degree in a behavioral health field such as psychology, social work or a degree in nursing is required.

Experience:
– Minimum five to seven years’ experience managing staff in a behavioral healthcare organization required.

Experience Preferred/Desirable:
– Clinical supervisory experience with a Medicaid managed care population preferred.

Certification or Conditions of Employment:
– Current certificate or state licensure in Massachusetts as RN, LICSW, LMHC, Clinical Nurse Specialist, or Licensed Psychologist

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