Director of Behavioral Health & Substance Use Disorder Programs, South San Francisco, CA
DIRECTOR OF BEHAVIORAL HEALTH & SUBSTANCE USE DISORDER PROGRAMS
The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Director of Behavior Health to perform the following essential duties & responsibilities:
- Assess overall program performance and initiate continuous improvements in services and outcomes that achieve Medicare Five Star, HEDIS, and NCQA outcomes/accreditation.
- Develop and implement key strategies to advance HPSM’s effort to achieve high performance in behavioral health and integrated care that align with the enterprise mission/vision.
- Financial management of resources and key contracts to impact program contributions and clinical outcomes.
- Analysis of data to support development of cost-effective strategies to help HPSM achieve improved overall health outcomes through targeted behavioral health and substance use disorder service interventions.
- Management and oversight of key delegated relationships with BHRS and the autism benefits administrator by monitoring the following: Utilization management, Care coordination, Quality, Claims administration, Customer service, Network management and Compliance with Medicare and Medicaid regulations and contracts.
- Develop and promote relationships and partnerships within the community and behavioral health profession.
- Maintain effective direct and matrix reporting relationships within HPSM, BHRS and other key relationships.
- Contribute to the ongoing development and integration of the HPSM’s Model of Care.
- Direct and provide enhancements to business processes, policies, and infrastructure to improve operational efficiency.
- Serve as a liaison or subject matter expert with regulatory (DHCS, CMS, DMHC, etc) and accrediting agencies.
- Maintain awareness and knowledge of national affairs, policies and legislation related to behavioral health and substance use disorders as appropriate to HPSM’s accountabilities.
- Act to promote member centric programming and achieve high level of member satisfaction.
Education and Experience:
- Master’s Degree in the field of behavioral health, nursing, social work or a related human service field.
- Clinical behavioral health license required.
- Five (5) or more years of management level experience in health care preferably leading major clinical programs.
- Four (4) years of clinical practice experience.
- Principles and operation of managed care, specifically related to health plan operations.
- Personal Computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel and PowerPoint.
- Effectively utilize clinical data, database management, data analysis and reporting
- Lead programs and processes through team facilitation, project management, and change management
- Work with physician/provider relationships in a leadership position
- Work as part of a team and support team decisions.
- Communicate effectively, both verbally and in writing.
- Adapt to changes in requirements/priorities for daily and specialized tasks.
Compensation & Benefits
Starting Compensation Range: - $120,000/ to $157,000. Annually - depending on experience
Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s Medical, Dental and Vision coverage. Employee pays a small portion of the dependent premiums (5%) for medical and dental benefits. Additional HPSM benefits include fully paid life, AD&D, STD, and LTD insurance; retirement plan (HPSM contributes equivalent of 10% of annual compensation); holiday and vacation pay; tuition reimbursement plan; onsite fitness center and more. Check out our full benefits package at: https://www.hpsm.org/abouthpsm/employment-opportunities.aspx (Under Employee Benefits Tab)
Application Process: To apply, submit a resume and cover letter with salary expectations to: Health Plan of San Mateo, Human Resources Department, 801 Gateway Blvd., Suite 100, South San Francisco, CA 94080 or via email: firstname.lastname@example.org or via fax: (650) 616-8039. File by: Continuous until filled. EOE