Partnership HealthPlan of California · 2 weeks ago
Sr. Manager of Behavioral Health Access
US-CA-Fairfield
Full-time
Onsite
Senior Level
$136K/yr - $177K/yr
5+ years expPartnership HealthPlan of California is seeking a Sr. Manager of Behavioral Health Access to direct and coordinate medically necessary behavioral health treatment services for members. The role involves overseeing operations of the Behavioral Health Call Center, ensuring regulatory compliance, and managing staff to enhance the member experience.
Health CareInsuranceNon Profit
Responsibilities
Manages the day-to-day operations of the behavioral health call center
Builds strong, competent staff to enhance the member experience, which may include supporting access to care and ensuring closed loop referrals
Accountable for developing performance standards and implementing monitoring mechanisms to ensure service level expectations are met
Responsible for program evaluation and oversees training, creation of policies and procedures, and facilitation of meetings and projects
Plans, implements and provides ongoing direction for quality assurance and quality improvement activities of the Behavioral Health member experience team
Works with department leadership and internal stakeholders to ensure Behavioral Health Department is meeting intended goals in support of the member experience
Monitors and evaluates the efficiency and effectiveness of service delivery methods and procedures
Represents the Behavioral Health Department at meetings and maintains relationships with internal and external stakeholders, community partners, and regulatory agencies
Ensures regulatory compliance and performance standards for the Call Center
Provides day-to-day oversight and support of the Behavioral Health Access staff
Establishes operational workflows, best practices and continuous improvement activities
Participates in the development of departmental policies and procedures
Assists with development of system changes or upgrades as needed
Facilitates and/or attends appropriate committees, meetings, and trainings
Participates in the development and revision of member materials
Provides backup on phones as needed including the screening of members using proscribed screening tools and directs members to appropriate providers
Assists with compliance of DHCS, DMHC, CMS, and NCQA requirements and standards
Oversees review and processing of daily, weekly and monthly access line reporting to ensure timely access, closed loop referrals, and call performance measures are met
Oversees operations of staff managing specialized case load of members with behavioral health needs which interfere with positive healthcare outcomes
Collaborates and consults with care providers, member, and/or the multidisciplinary care team to assist in understanding the members behavioral health needs
Acts as a support/resource to others within the organization for behavioral health cases
Knowledge of and ability to coordinate with multiple systems of care including county-based behavioral health services
Functions collaboratively in a team environment
Utilizes best practices in coordination of behavioral health services in accordance with established guidelines associated with access line workflows
Coordinates with medical providers, psychiatrists, drug and alcohol counselors, case managers, and other support staff to ensure continuum of care
Oversees the performance of screenings to assist in coordinating behavioral health services
Maintains accurate and timely documentation, records, and case files in the Partnership HealthPlan of California (Partnership) Case Management System for members in behavioral health access line management system
Develops and maintains knowledge of a community-based network of alternative modes of care
Aids member to connect with community-based organizations to support and enhance wellness
Conducts and contributes to special training for Partnership staff, professionals, public and private agencies and others as identified
Assists with training and relevant educational materials for Behavioral Health Access Guides
Handles complex and lengthy calls that cannot be resolved by the Behavioral Health Access Guides or Leads
Attends and delivers community presentations and orientations as needed
Educates members and providers on the guidelines and policies of Partnership
Assesses and resolves problems within scope of authority; escalates unusual questions or problems to higher authority levels
Communicates clearly and effectively through all mediums of communication with members, providers, vendors, community partners, and Partnership employees
Supports successful transition of care for members discharged from a residential setting transitioning to a lower level of care within the community, to include assessing member needs and identifying appropriate staff to carry out identified needs, effective and frequent communication with providers, members, county partners and identified health care designee
Performs other duties as assigned including the assumption of new duties
Qualification
Required
Master's degree in a behavioral health related area preferred; at least five (5) years of relevant program management experience required
In lieu of a degree, a minimum of eight (8) years of relevant experience to include a minimum of five (5) years management experience will be considered
Experience managing program teams with multiple position levels
Ability to actively listen, engage members who may be having active behavioral health challenges by using motivational interviewing techniques
Considerable knowledge of prevention, treatment and rehabilitation techniques used in the identification and treatment of mental illness and emotional disorders
Federal, state and local laws, rules and regulations associated with mental health treatment and education programs
Understanding of the treatment of mental illness and substance use disorders
Valid California driver's license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business
Strong organizational, communication, attention to detail and critically thinking skills required
Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines
Ability to work across systems of care and engage members and providers to coordinate care and services
Effective telephone and computer data entry skills required
Experience in managed care business practices and ability to access data information using computer systems
Excellent English written and verbal communication skills
Preferred
Experience in publicly funded behavioral health and in a health plan environment preferred
Company
Partnership HealthPlan of California
Partnership HealthPlan of California is a non-profit community-based health care organization that contracts with the state to administer Medi-Cal benefits through local care providers to ensure Medi-Cal recipients have access to high-quality comprehensive cost-effective health care.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
L
Lorna Veloso
Sr. Manager of OpEx/PMO
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