Director, Clinical Behavioral Health | Behavioral Health SME - TACOMA/Seattle
Truly make a difference in healthcare in this community as part of this innovative health plan. KEY leader will develop a high performing, fully integrated medical management team, working in collaboration with the VP and peer Medical Management Directors. If you are a behavioral health SME who understands managed care, this may be THE opportunity to accelerate your career.
-Director will oversee clinical functions in all service areas including: intensive case management (ICM), utilization review (UR), provider training and care coordination and ensuring processes are consistent with URAC and NCQA guidelines and state mandates.
- Drive implementation of new business and participate in RFP writing and in policy modification.
- Develop clinical initiatives and monitor ICM, UR and disease management programs.
- Develop program descriptions and evaluate programs to meet set guidelines.
- Interface with network development and Quality Improvement.
-Master's degree in Behavioral Health or related field.
-5+ years of related experience in a managed care setting with experience in utilization management or case management.
-Proven leadership success in developing effective teams.
- Ideal candidate will have Strong Performance Management/Improvement experience, be analytical and data driven with CQI mind set. (LEAN experience a plus)
- Community experience and relationships; demonstrated successful collaboration on multi-stakeholder projects
License/Certification: Unrestricted license as a LCSW, LMFT, LPC, PhD, PsyD or RN