Job Description
About Us:
Santa Clara Family Health Plan (SCFHP) is a local, community-based health plan dedicated to improving the health and well-being of the residents of Santa Clara County. Working in partnership with providers and community organizations, we serve our neighbors through our Medi-Cal and Cal MediConnect (Medicare-Medicaid Plan) health insurance plans.
About the role:
The Manager of Behavioral Health is responsible for the direct oversight of internal and external case management processes including the development and implementation of policies, procedures that support the Behavioral Health Program. In addition, the Manager of Behavioral Health is responsible for supervising the Social Work Case Managers and Behavioral Health (BH) Personal Care Coordinators to ensure that quality of coordinated care and cost effective services are available to all members in accordance with all applicable state, federal and NCQA regulatory requirements, SCFHP policies and procedures and business requirements.
Day to Day:
- Develop, implement and manage Behavioral Health case management, utilization management, and quality review processes for continuous compliance with all applicable state, federal and NCQA regulatory requirements, SCFHP policies and procedures and general business requirements, for all lines of business.
- Develop and implement continuous analysis and quality monitoring of all policies and procedures to evaluate staff performance and ensure regulatory compliance, including the development and implementation of effective, measurable corrective action plans to meet targeted strategic outcomes.
- Ensure the integration of BH case management operations into other internal and external teams/departments including Quality Improvement (QI), Long Term Services and Support (LTSS) and Case Management (CM).
- Report on BH and BHT at Joint Operating Committees (JOC) and Memorandum of Understanding (MOU) committee meetings.
- Represent SCFHP in interactions with community stakeholder meetings.
- Organize and participate in internal interdisciplinary care team (ICT) meetings with BH focus, as needed.
- Recruiting, interviewing, and hiring. Developing a high performing department culture and staff. This includes setting the standard for staff/peers and motivating employees to maximize organizational goals and objectives.
- Effectively assimilating, training and mentoring staff and (when appropriate), cross training existing staff and initiating retraining. This includes coaching to help increase skills, knowledge and (if applicable) improve performance.
- Setting goals and planning, assigning, and directing work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
- Appraising performance, rewarding and disciplining employees, addressing complaints and resolving issues. This includes providing regular and effective feedback to employees and completing timely and objective performance reviews.
About You:
- Unrestricted License Clinical Social Work (LCSW) or Licensed Psychologist (PsyD or PhD) in the state of California.
- Minimum five years of experience in social work, behavioral health, or case management.
- Minimum one year of progressively responsible experience in a supervisory or lead role.
- Current working knowledge of BH Case Management practices
- Current working knowledge of Medicare, MediCal regulations and NCQA Population Health standards.
- Ability to consistently meet accuracy and timeliness requirements to maintain regulatory requirements.
- Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications such as Outlook, Word, Excel, and specific case management and claims programs.
Please review the full job description on our Career’s page:
https://phf.tbe.taleo.net/phf04/ats/careers/v2/viewRequisition?org=SANTCLAR2&cws=38&rid=2882
Job Type: Full-time
Pay: $99,315.00 - $153,938.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Referral program
- Vision insurance
Schedule:
Application Question(s):
- Do you have an unrestricted License Clinical Social Work (LCSW) or a Licensed Psychologist (PsyD or Ph.D.) in California?
Experience:
- Social work, Behavrioral health, or Case Management: 5 years (Required)
- Supervisory or Lead: 1 year (Required)
Work Location: In person