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Director, Behavioral Health

Job Category:  Management/Executive
Department:  Behavioral Health
Location: 

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  8136

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

As a condition of employment, L.A. Care requires a COVID-19 vaccine. This requirement includes our remote workforce. If you would like to request an exemption, L.A. Care has implemented a process to consider exemptions, for documented medical conditions and sincerely held religious beliefs. L.A. Care will review all exemption requests prior to proceeding with the recruitment process.

Job Summary

The Director of the Behavioral Health serves on the Behavioral Health Management Team and reports to the Medical Director, Behavioral Health. This position is responsible for the oversight of clinical and operations functions within the department. The director serves as a behavioral health subject matter expert in internal meetings throughout L.A. Care and external meetings with varied partners and stakeholders. This position pursues positive outcomes in the areas of quality of care, service utilization, member and consumer affairs, network enhancement, and data management. The Director conducts strategic planning to utilize resources in order to meet current and future departmental, Health Services, and Enterprise-wide goals.

Duties

Leads internal and external meetings related to staffing, regulatory updates, Quality Improvement, and collaborations with Los Angeles County agencies, in collaboration with the Medical Director, Behavioral Health.

 

Engages in budget and personnel planning to support the priorities of the department and the organization to ensure that available staffing and budgetary resources are allocated based on prioritization.

 

Manages L.A. Care's contractual relationship with behavioral health contracted entities. Validates vendor fulfillment of contractual obligations and develops performance improvement plans to ameliorate deficiencies. Seeks enhancement of behavioral health network through contracting efforts with provider groups and direct contracting.

 

Directs and supervises the Managers of the Consumer Affairs, Clinical, and Autism/Early Intervention teams within the department, as well as departmental Operations staff.

 

Collaborates with contracted entities to pursue process improvement, service integration and dispute resolution.

 

Fosters productive relationships with a diverse array provider groups, including non-specialty and specialty mental health, substance abuse treatment, and primary care provider groups.


Confers with the leadership of Case Management, Medical (utilization) Management, Social Services, Disease Management, and Provider Network Management to optimize workflows.

 

Creates and updates plan policies and procedures to ensure adherence to internal standards and regulatory requirements. Responds to regulatory queries from internal and external auditors.

 

Leads the BH Quality Improvement program and workgroups to address HEDIS measures and National Committee for Quality Assurance (NCQA) requirements.


Perform other duties as assigned.

Education Required

Bachelor's Degree in Clinical Psychology

Education Preferred

Master's Degree in Clinical Psychology
In lieu of degree, equivalent education and/or experience may be considered.

Experience

Required:
Minimum of 6-8 years experience in behavioral health operations in a managed care or healthcare environment.

 

At least 5 years of supervisory/management experience.

 

Knowledge of substance abuse, community mental health, specialty mental health services, and networks of care.

 

Knowledge of National Committee for Quality Assurance (NCQA) standards and Healthcare Effectiveness Data and Information Set (HEDIS) measures and strategic approaches to Quality Improvement.

 

Preferred:  
Experience in implementing Medicaid and Medicare program requirements for Behavioral Health.

Skills

Required:
Strong writing and analytical skills.

 

Advanced computer skills.  

 

Knowledge of cross-cultural aspects of L.A. Care's socially and ethnically diverse population. Knowledge of principles and practices associated with the rights and responsibilities of patients and providers.

 

Knowledge of Principles and Practices of health care, health care systems, and managed care. Knowledge of the full spectrum of outpatient, inpatient, and long-term behavioral health services and the authorization processes for these services.

 

Knowledge of Medi-Cal and/or Medicare benefits and regulations. Knowledge of Health Plan, Hospital and Medical Group operations and strategies.

 

Knowledge of Community-based organizations, agencies and community services.

 

Leadership and collaboration skills to work with all stakeholders to solicit input and reach sound decisions in coordinating care.

 

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Additional Information

 

L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)

 

At L.A. Care, we value our team members’ safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.


Nearest Major Market: Los Angeles

Job Segment: Behavioral Health, Substance Abuse, Counseling, Medicare, Social Services, Healthcare, Service

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