job

About the Position:

The Vice President of Behavioral Health (BH) is accountable for BH cost, quality and compliance goals across the Plan’s Markets and Products as well as the development of programs to meet the overall strategic direction of the plan’s BH programs and functions. The Vice President leads the projects and initiatives to integrate BH programs and operations into the plan. The Vice President has direct oversight responsibility of a multidisciplinary team that provides BH care management, operational quality assurance and quality initiatives, programs and services. The Vice President ensures operational, strategic and tactical alignment across the business, markets and enterprise, including the Office of Clinical Affairs, Disease/Care Management, Quality Management, Network Management, Utilization Management and other enterprise shared services. The Vice President represents the Plan in high visibility, high profile external settings involving BH and is accountable for business development and growth.

We are looking for a strong managed behavioral health leader with a deep understanding of integrated, whole person care. The successful candidate will approach this role with a great deal of collaboration and flexibility and will have the opportunity to create and execute the organization’s behavioral health strategy. The ability to grow and mentor the team and manage internal/external stakeholder relationships will be critical to this role. The Vice President must have strong change management and vendor management skills with demonstrated experience ensuring quality metrics are achieved. The Vice President will be joining a mission driven, provider-owned organization and must have the ability to work effectively with functional leaders across WellSense and Boston Medical Center Health System.

Key Functions & Responsibilities:

-Develops and oversees integration of BH across plan all functions and manages relationship with behavioral health vendor.
-Direct responsibility for BH CM, Operations and Quality through overseeing a BH leadership team.
-Responsible for all Market BH activities through Market BH Leadership.
-Develops and executes new strategic BH initiatives with BH subcontractor, where appropriate, designed to support corporate goals including strategic operating priorities and NCQA accreditation.
-Drive innovation within behavioral health while improving the health of the population in a cost effective way and differentiating WellSense as a provider of choice.
-Develops new and enhances existing relationships with BH Trade Organizations and BH providers within Massachusetts and New Hampshire.
-Represents the Plan at BH Trade Organizations’ meetings.
-Working collaboratively with Public Partnerships, Executive leadership and the BH subcontractor as appropriate, utilizes relationships and regulatory requirements to manage environmental strategic position related to Plan business across markets.
-Assesses BH strategic needs based on the environment and Plan priorities; plans for new programs in collaboration with subcontractor.
-Strategically plans and implements BH program for new products and business models.
-Leads contract negotiations for behavioral health line of business in conjunction with quality, finance, legal, compliance and clinical.
-Accountable for WellSense’s BH care management program to include processes, operations and functions.

Qualifications:

Education:

-Master’s degree in a behavioral health discipline or the equivalent combination of training and experience is required.
Education Preferred/Desirable:

-Independent licensure (LICSW, LMHC, Ph.D., Psy.D., RNCS, etc.) preferred, but not required.

Experience:

-8+ years of related experience in a behavioral health setting with a minimum of 3 years of experience in a managed care setting; experience overseeing a large behavioral health managed care organization and BHO from a strategic perspective

-Experience managing product / market expansion and implementations is strongly preferred.

-5 years of experience managing key stakeholder relationships.

-Experience with Medicaid and/or Medicare recipients and community services.

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