Director, Behavioral Health Operations

$136,550 - $166,850/Yr

Careoregon - Seattle, WA

Full-time - Director

Remote - Seattle, WA

Insurance Carriers and Related Activities

About the position

The Director, Behavioral Health Operations role at CareOregon is a pivotal position responsible for overseeing, coordinating, and continuously improving the Behavioral Health Portfolio, initiatives, and operations. This role is designed to promote high levels of collaboration and integration both within and between departments to advance the strategic plan development and deployment, as well as the operational implementation of priorities that impact Behavioral Health across all business lines. The position is fully remote, but candidates must reside in one of the specified states: Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. In this role, the Director will lead the execution, management, and oversight of strategic initiatives, plans, and goals in behavioral health operations. This includes ensuring the effective integration and execution of behavioral health policies and activities across all lines of business, while ensuring compliance with state and federal regulations. The Director will also pursue administrative simplification by identifying opportunities to integrate behavioral health operations with other operational units of CareOregon. A strong emphasis will be placed on regulatory compliance, leveraging advanced knowledge of Medicaid, Medicare, and Managed Care regulations, as well as industry trends and best practices. The Director will participate in the development of vision, goals, and strategic plans for the department, providing input into the organization’s strategic plans. They will manage resources effectively to ensure that priorities are accomplished, recommending budgets in alignment with both short and long-term plans. Relationship management is key, as the Director will lead effective communication systems for work groups and build strong relationships across internal teams and external organizations. Additionally, the Director will supervise teams, establishing direction and goals that align with the organizational mission, vision, and values. They will be responsible for recruiting, hiring, and overseeing a team, ensuring that employees have the necessary information and resources to meet job expectations. The role also involves evaluating employee performance and providing regular feedback to support success, while promoting a culture of equity, diversity, and inclusion within the team.

Responsibilities

• Lead the execution, management, and oversight of strategic initiatives, plans, and goals in behavioral health operations.
• Oversee the effective integration and execution of behavioral health policies and activities across all lines of business, ensuring alignment with state and federal regulations.
• Ensure effective, efficient, and compliant Behavioral Health plan operations in partnership with leaders from various CareOregon operational business units.
• Pursue administrative simplification by identifying opportunities to integrate behavioral health operations with operational units of CareOregon for other benefit types.
• Ensure regulatory compliance for all areas of responsibility, leveraging advanced knowledge of Medicaid, Medicare, and Managed Care regulations.
• Recognize, adopt, and implement continuous quality improvement (CQI) best practices and metrics to obtain desired strategic and tactical results.
• Provide guidance, content expertise, and technical assistance to CareOregon's partner CCOs, providers, and community-based behavioral health and primary care organizations.
• Create and monitor dashboards and leverage service and population data and utilization and outcomes analytics to help assure success in meeting internal and external benchmarks.
• Participate in the development of vision, goals, and strategic plans for the department.
• Provide input into the strategic plans of the organization and develop short and long-term plans and policies.
• Manage resources to ensure priorities are accomplished and approve resource allocations within budget.
• Lead effective communication systems for work groups, ensuring a collaborative culture.
• Build and ensure effective relationships and communication systems across internal teams and external organizations for collaboration.
• Direct team(s) and establish team direction and goals in alignment with the organizational mission, vision, and values.
• Evaluate employee performance and provide regular feedback to support success.

Requirements

• Minimum 10 years' related experience, including the areas of behavioral health, quality, and/or operations.
• Minimum 4 years' experience in a supervisory position (preferred).
• Advanced degree in health care related field (preferred).
• Certification in Healthcare Quality (CPHQ) or Healthcare Compliance (CHC) (preferred).
• Work experience with Oregon Medicaid and/or OHP behavioral health benefits (preferred).
• Comprehensive knowledge of Medicaid and Medicare regulations for health plans and network providers regarding compliance, quality assurance, and operations.
• Solid knowledge of health plan finance and the compensation arrangements between health plans and providers.

Nice-to-haves

• Experience in a supervisory position in a healthcare setting.
• Advanced degree in a healthcare-related field.
• Certification in Healthcare Quality (CPHQ) or Healthcare Compliance (CHC).
• Work experience with Oregon Medicaid and/or OHP behavioral health benefits.

Benefits

• Estimated hiring range $136,550 - $166,850 / year
• 10% bonus target
• Full benefits package including health insurance, dental insurance, and retirement plans.