Manager, Behavioral Health

Company: Centene Corporation
Location: Tacoma
Posted on: August 5, 2022

Job Description:

Position Purpose: Position is responsible for ensuring that the MCO's behavioral health operations, which include the operations of any MCO behavioral health subcontractors, are in compliance with the terms of the MCO's contract with the State Coordinate with all MCO functional areas, including quality management, utilization management, network development and management, provider relations, member outreach and education, member services, contract compliance, and reporting. Participate in all quality management and improvement activities, including participating in key State stakeholder committees Work closely with MCO network development and provider relations staff to develop and maintain the behavioral health network and ensure that it is fully integrated with the physical health provider network. Partner with UM staff to monitor behavioral health utilization, especially to identify and address potential behavioral health under -or over-utilization. Act as primary liaison with behavioral health community resources, including Community Mental Health Centers (CMHCs) Responsible for all reporting related to the MCO's provision of behavioral health services. Oversee subcontracts related to behavioral health servicesFor PA H only: Monitor the CHC-MCO for adherence to BH requirements in the Agreement. Coordinate Participant care needs with BH Providers. Develop processes to coordinate behavioral healthcare between PCPs and BH Providers. Participate in the identification of best practices for BH in a primary care setting. Coordinate behavioral care with medically necessary services. Be knowledgeable of the BH Managed Care Agreement requirements and coordinate with the BH-MCO to effectuate the requirements.Qualifications:Education/Experience: Bachelor's degree in Social Services, Psychology, Health Administration, or related field. Master's degree in a Behavioral Health specialty preferred. 5+ years related experience. Working knowledge of Medicare, Medicaid and health plan administration. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.For Fidelis Care only:The HCBS Compliance Manager works in the Behavioral Health division, HARP product line, providing daily support, guidance, and direction to the HARP Care Managers and Service Coordinators who serve the HARP population. This role coordinates and supervises the activities and performance of HARP staff and Health Homes to ensure goals are met or exceeded with respect to HCBS benefits and services, and ensures compliance with all regulatory, contractual, and organizational requirements.License/Certification: NYS unrestricted license as Registered Nurse (RN), Physical Therapist (PT) or Occupational Therapist (OT)For PA H only: Behavioral health professional located in Pennsylvania.For New Hampshire Health Families Only:Master's Degree in Social Work, Psychology, Education, Public Health or a related field. 8+ years of related experience both in the provision of direct care services as well as progressively increasing levels of management responsibilities. LCSW, LMFT or LPC, or a PhD, PsyD or RN required.For Nebraska Total Care Only: Must be a licensed behavioral health professional, such as a psychologist, psychiatrist, social worker, psychiatric nurse, marriage and family therapist, or mental health counselor.For Iowa Total Care only: Employee shall be an Iowa licensed behavioral health professional such as a psychologist, psychiatrist, social worker, psychiatric nurse, marriage and family therapist or mental health counselor, with experience in both mental health and substance use disorder services. The Behavioral Health Manager shall ensure that the Contractor's behavioral health operations, which include the operations of any behavioral health subcontractors, are in compliance with the terms of the Contract.FL License Requirement: RN, LCSW, LCMHC or other Mental Health Professional licenseFor Home State Health Plan (Missouri) only: Either a Missouri-licensed Mental Health Clinical Nurse Specialist, Mental Health Nurse Practitioner, or a Missouri licensed psychologist; A Qualified Behavioral Healthcare Professional (QBHP); and Master's degree.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Keywords: Centene Corporation, Tacoma , Manager, Behavioral Health, Healthcare , Tacoma, Washington