Umpqua Health is a Coordinated Care Organization (CCO) in Roseburg, Oregon that serves over 30,000 OHP members within Douglas County, offering benefits, programs and outreach for those in need. Currently we are seeking a Behavioral Health Operations Manager, Adult, to join our Behavioral Health team.
Full-time Remote position. Must live in Oregon or Washington and would be expected to come into the office up to 1-2 times per month as needed in Roseburg, Oregon.
Generous benefit package including; PTO, Health/Vision/Dental Insurance, 401k with a company match, gym membership reimbursement and more
Salary is dependent upon experience.
This position is responsible for the management of Umpqua Health's strategic initiatives for behavioral health programs serving adults in Douglas County, including service delivery. Spearhead innovation and continuous improvement of adult behavioral health services and programs in alignment with the Oregon Health Authority's strategic plan. Develop and operationalize new programs in addition to the oversight and evaluation of existing programs. Enforce ORS and OARs as they pertain to position scope. Leverage healthcare industry expertise to draft policies, research and interpret regulations, and summarize data for narrative contract deliverables and other reporting requirements. This position will support the Director of Integrated Clinical Services and key stakeholders to implement UHA's behavioral health benefit and deliverables with a focus on health equity aimed at addressing disparities in healthcare for adults in UHA's service area.
ESSENTIAL JOB RESPONSIBILITIES
Program Development
Assist in the development of Behavioral Health programs to meet the strategic initiatives of UHA for adult services
In collaboration with the Director of Integrated Services, ensure that programs satisfy contractual and regulatory requirements.
Report on all aspects related to program/project activities to ensure strategic initiatives are met.
Operationalize workflows, policies, and standard operating procedures for all population specific programs including transformation and integration initiatives.
Establish positive and proactive relationships with state, county, community providers, and internal stakeholders
Maintain updated knowledge of the Oregon Administrative Rules (OAR) governing OHP and HIPAA
Support the identification and development of culturally and linguistically appropriate resources to support the needs of adults located in Douglas County
Program Oversight
Collaborate on the development of metrics to monitor incentive metrics, health outcome metrics, access, and overall compliance.
Monitor fidelity programs and services for adults including but not limited to: ACT, CHOICE, and Supported Employment). Evaluate program performance and consistency. Initiate corrective action process to remediate organizational compliance risk.
Develop and oversee the production of standard reports to monitor and evaluate program outcomes. Monitor performance to metrics quarterly, and ad hoc as needed
Collect and monitor regular reporting from community partners, organizational databases, event notification systems, and internal staff to assess and analyze gaps in services.
Identify, track, and resolve risks. Develop contingency plans to support successful completion of initiatives.
Collaborate, gather data, and complete Behavioral Health reporting requirements for adult services and pursue grant opportunities with community partners, industry leaders, community stakeholders and subject matter experts.
Responsible for project specific requirements, coordination, and deliverables as outlined in project plans and/or grant agreements including grant oversight and administration as specified in the grant agreement(s).
Work in concert with Care Coordination leadership and Director of Integrated Clinical Services to complete Exhibit M reporting deliverables.
Serve as the key technical contact and subject matter expert for external and internal stakeholders regarding subject matter consultations for adult serving behavioral health programs
Continuous Process Improvement
Identify opportunities to improve existing operational policies and procedures
Develop new policies and standard operating procedures as necessary
Ensure continuous quality improvement by collaborating with key stakeholders to ensure necessary training and updates are implemented
Accountable for tracking metrics, goals, and outcome targets where applicable and
Implement operational changes in partnership with Care Coordination leadership, Director of Utilization Management, and Director of Integrated Clinical Services as they relate to department metrics and clinical program performance.
Provide technical assistance and/ or in-service training programs for staff and community groups, as needed.
Monitor internal audits of the health plan to support effective performance of processes and procedures
Proactively identify, escalate, and resolve operational and/or practice-based issues of moderate complexity to maintain overall quality and effectiveness.
Establish, implement, and annually review Behavioral Health policies, Standard Operating Procedures, Provider Contract(s), and other pertinent administrative documents as required.
QUALIFICATIONS
REQUIRED - Master's degree in psychology, social work, or counseling plus two (2) years' experience in behavioral health care.
REQUIRED - Experience in Adult Behavioral Health, as well as any of the following: utilization management, care coordination, managed care, or health plan administration.
PREFERRED- Oregon State Board licensure as a mental health professional (Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), or Licensed Psychologist)
PREFERRED- MHACBO Certification as CADC I or higher
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