Resp & QualificationsPURPOSE:Expert clinical practitioner responsible for providing direct management and oversight of all behavioral health services to include all functions of behavioral health care management and the programs and services that support the behavioral health and substance use disorder patient care populations. These programs may include utilization management, vendor oversight, and clinical strategy development and oversight. Provides strategic leadership in design and implementation of a cogent behavioral health strategy to ensure strategic alignment with divisional and corporate goals, and with the needs of members, providers and accounts.We are looking for an experienced leader in the greater Baltimore metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week.ESSENTIAL FUNCTIONS:
Develops departmental policies and procedures for behavioral health services. Provides strategic direction and develops and maintains quality-improvement programs to optimize patient care. Oversees care coordination activities related to behavioral health and substance use disorder.
Collaborates with physicians/provider leaders to ensure service expectations are being met.
Serves as a resource for the behavioral health management team and other departments.
Establishes the workflow of care managers, social workers and discharge planners.
Presents status of key performance indicators and make recommendations on continuous improvement opportunities to the executive leadership team.
Maintains and develops relationships with key thought and business leaders in the health care delivery marketplace.
Directs the strategic and the day-to-day activities of the Department, including coaching and guiding individuals and teams in order to implement departmental, divisional, and organizational mission/goals. Recruits, retains and develops a high performing team. Evaluates performance of each team member, generates development plans and sets goals within the context of the corporate policies and procedures. Develops annual goals, and prepares, monitors, and analyzes variances of departmental budgets in order to control and appropriately allocate resources.
SUPERVISORY RESPONSIBILITY:This position manages people.QUALIFICATIONS:Education Level : Master's Degree in Mental Health; education can be in one or more of the following areas: Social Work, Psychology, Nursing or Counseling.Licenses/Certifications:
LCSW- License Clinical Social Worker Upon Hire Required or LMAFT - Lic-Marriage & Family Therapy Upon Hire Required or LPC-Licensed Professional Counselor Upon Hire Required.
Experience:
8 years post masters clinical behavioral health/psychiatric experience.
3 years management experience.
Preferred Qualifications:
Doctoral degree in Psychiatric Nursing or Mental Health.
Experience with managed behavioral healthcare and/or behavioral healthcare within the setting of a health insurer strongly preferred.
Knowledge, Skills and Abilities (KSAs)
Ability to communicate effectively verbally and in writing.
Knowledge of health benefits industry, products, trends, consumer market, and competitive intelligence.
Knowledge and proficiency in use of metrics and measures in managing programs and services.
Strong organizational skills to manage multiple projects, issues and priorities.
Extensive knowledge of managed care delivery guidelines and systems.
Extensive knowledge of behavioral health diagnoses.
Demonstrated application and knowledge of best behavioral health clinical practices.
Demonstrated advanced knowledge and skills in the areas of clinical expertise, evidence-based practice, and providing the related consultation, education, mentoring.
Requires ability to model excellence in advanced behavioral health clinical practice within a specialty population.
Skilled at being persistent, modifying tactics based upon reading another person's statements and body language.
Ability to mentor and coach associates to accomplish goals, provide objective evaluation of associate performance, and implement strategies to improve individual and team-based performance as needed.
Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Salary Range : $130,240 - $241,758Salary Range DisclaimerThe disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).DepartmentCore Clinical Operations AdministrationEqual Employment OpportunityCareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.Where To ApplyPlease visit our website to apply: www.carefirst.com/careersFederal Disc/Physical DemandNote: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.PHYSICAL DEMANDS:The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.Sponsorship in USMust be eligible to work in the U.S. without Sponsorship#LI-NH2REQNUMBER: 19876