Managing Director of Behavioral Health

US-RI-Smithfield
Req No.
2017-7812
Department
Behavioral Health
Type
Regular Full-Time
Category
Executive

Overview

The Managing Director of Behavioral Health leads the company’s integrated Behavioral Health efforts to include strategy and planning, financial measures, compliance, vendor management and quality results/measures. Primary responsibilities are to manage the BH vendor contract and lead clinical strategy for integration of BH in collaboration with Medical Management

Responsibilities

  • Manage contract with behavioral health vendor
    • Under the direction of the CMO and working closely with the BH staff, develop contract terms to integrate BH with medical management to create optimal member outcomes and a positive financial effect on medical expenses
    • Manage the BH contract team and develop service level agreements (SLAs) to provide vendor oversight
    • Define performance KPI’s and track vendor performance, and take associated steps to enable accountability
    • Renegotiate and re-evaluate vendor contract when necessary
  • Strengthen integration of BH vendor services
    • Collaborate with CMO, VP of Medical Management and Medical Directors to develop strategy and policies and procedures for integrating BH data and services as part of medical management
    • Oversee vendor data sharing of BH case management data
    • Monitor and evaluate BH/medical integration policies based on estimated impact on clinical outcomes
    • Update and improve integration policies as required
  • Set overall strategic direction of behavioral health, including:
    • Evaluating potential for improving overall behavioral health experience and outcomes
    • Integrating behavioral health needs with social determinants
    • Working with the community (physicians and others) to provide a better experience
    • Evaluating potential of bringing behavioral health in-house
  • Represent NHPRI on state boards and/or initiatives and with state agencies as required

Qualifications

Required:

  • MD/DO, NP/RM or MSW with strong administrative skills
  • 5+ years of Health Plan experience
  • 2+ years of Behavioral Health administrative experience
  • 2+ years of clinical practice experience
  • Strong knowledge of behavioral health medical management integration
  • Two (2)+ years’ experience with contract negotiations and contract management
  • Experience with Medicare, Medicaid and Commercial

Preferred:

  • Psychiatrist or psychologist
  • Lean/Six Sigma
  • Experience leading a behavioral health department at a health plan
  • Experience establishing in-house behavioral management program at a health plan

Neighborhood is an Affirmative Action and Equal Opportunity Employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, genetic information, age, disability, veteran status or any other legally protected basis.

Neighborhood is committed to ensuring individuals with disabilities and/or those who have special needs participate in the workforce and are afforded equal opportunity to apply for jobs. If you would like to contact us regarding the accessibility of our Website or need assistance completing the application process, please contact us at  recruiting@nhpri.org

 

Neighborhood is an EOE M/F/D/V and an E-Verify Employer

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