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 Manager, Behavioral Health Care Coordination, to join our Medical Management 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
• Starting salary at $77K. Salary is dependent upon experience.

The Manager, Behavioral Health Care Coordination directs the planning, management and evaluation of Behavioral Health Care Coordination team and support programs for Behavioral Health. Enforces ORS and OARs as related to the duties of this position, maintaining oversight and analysis of our Care Coordination programs including compliance, program development, evaluation, and performance monitoring. Provides administrative and clinical oversight to the behavioral health care coordination team, as well as direct supervision for assigned staff, including but not limited to Behavioral Health Care Coordinators and Navigators. Acts as liaison between assigned program areas, department management, and other State/County agencies; and a matrixed collaboration with department leadership in the over-all administration of the Behavioral Health program. Utilizes a high degree of clinical expertise in behavioral health conditions and evidence-based treatment including knowledge to provide leadership that is member-focused, strengths based, trauma-informed and culturally and linguistically appropriate. Manages Federal, State and managed care programs as assigned.
ESSENTIAL JOB RESPONSIBILITIES

• Support the hiring, training, supervision, and management of the Behavioral Health Care Coordination team.
• Maintain oversight of care plan development, implementation and follow up.
• Responsible for program(s) and project(s) under general direction of department leadership, including reporting on all aspects related to program/project activities to ensure strategic initiatives are met.
• Direct and manage clinical operational and management activities of the Care Coordination teams including the establishment and implementation of effective metrics to monitor KPI, health outcomes, and overall compliance.
• Develops and oversees the production of standard reports to monitor and report on overall Care Coordination metrics and behavioral health Care Coordination program evaluation.
• Accountable for tracking KPI metrics for Care Coordination goals and outcome targets where applicable and implementing operational changes in partnership with managers of Care Coordination as they relate to department metrics and clinical program performance.
• Meets with UHA leadership, state agencies, associates, and councils to acquire information related to programs.
• Assist in the development of Behavioral Health programs to meet the strategic initiatives of UHA Services.
• Develop program plans and objectives by researching and analyzing a variety of factors related to decision making process such as member needs, organization objectives, and key performance indicators in collaboration with Directors, other Department leadership, related agencies, community partners, consumers, and program staff.
• Collaborates, gathers data, and completes all Behavioral Health reporting requirements and potential grant opportunities with community partners, industry leaders, community stakeholders and subject matter experts.
• Works in concert with the Manager, Care Coordination to complete Care Coordination reporting deliverables.
• Identify opportunities to improve existing operational policies and procedures and develops new policies and procedures as necessary
• 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.
• Coordinates development of staff training and evaluation standards; Directs and conducts in-service training programs for staff and community groups.
• Ensure continuous quality improvement within the program, including peer reviews, quality assurance protocols, and documentation audits for quality care delivery.
• Prepares and presents program report and budget, which includes an assessment of program goals, needs, and progress on KPIs.
• Monitor internal audits of the health plan to ensure processes and procedures are being performed properly.
• Monitors program services to ensure compliance with statutory responsibilities, state administrative rules, and all related contracts.
• Develops and implements productivity standards and reports and analyzes productivity data. Leads changes to meet standards and to enhance productivity.
• Develop and implement efficient workflows for behavioral health program(s), including performance evaluations to proactively identify and resolve operational and/or practice-based issues to maintain quality and effectiveness.
• Foster collaborative work environment that encourages team building, facilitates cohesive synergetic performance of integrated Behavioral Health t functions, while valuing the individual diversity and uniqueness of all employees.
• Manage integration of Behavioral Health care coordination team in effective performance of job functions, which may include operations, quality, utilization care coordination, and delegated management oversight.
• Establish, implement, and annually review/update Behavioral Health policies, Standard Operating Procedures and other pertinent administrative documents as required.
• Collect and monitor regular reporting from community partners, organizational databases, event notification systems, and internal staff to assess and analyze gaps in coordinated service utilization, adjusting maximize performance as needed.
• Identifies, tracks, and resolves risks; and develops contingency plans to support successful project completion.
• May provide training and education to provider network on the availability of behavioral health services and other support services available, where appropriate.

• Knowledge of culturally specific issues, resources and strengths of the populations served.

• Review Culturally and Linguistically Appropriate services and materials available within provider network regularly.
• Demonstrate administrative, organizational, and critical-thinking skills while handling multiple tasks relating to diverse populations.
• Maintain updated knowledge of the Oregon Administrative Rules (OAR) governing OHP.
• Remain current on Medicaid and Medicare guidelines and benefits, the appeals and grievance process and the members’ rights and responsibilities as stated by the Division of Medical Assistance Program (DMAP) Oregon Health Authority (OHA) and Centers for Medicare and Medicaid Services (CMS), maintain working knowledge of Native American Oregon Health Plan Fee-For-Service program benefits.
• Comply with organization’s internal policies and procedures, Code of Conduct, Compliance Plan, along with applicable Federal, State, and local regulations.

QUALIFICATIONS

• REQUIRED - Master’s degree in social work or counseling plus two (2) years’ experience in behavioral care.
• REQUIRED - Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), or Licensed Psychologist.
• REQUIRED - Experience in Behavioral Health, utilization management, Care Coordination, and managed care.
• PREFERRED- CADC I and higher preferred.

For more information or to apply visit our website at www.umpquahealthcareers.com

Job Type: Full-time

Pay: $77,000.00 per year

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