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Director, Behavioral Health Services

Charlotte, North Carolina Apply Now Job ID 1144512 Category Health Insurance Operations Organization Carolina Complete Health Schedule Full-time
Description:
Position Purpose: Ensure that the behavioral health operations are in compliance with the terms of the contract with the State

  • Oversee all interaction with EOHHS and activities and communications and ensure that EOHHS is informed of all events and circumstances that materially affect delivery of behavioral health services
  • Delegate and participate in all quality management and improvement activities, including participating in key State stakeholder committees
  • Oversee all MCO functional areas, including quality management, utilization management, network development and management, provider relations, member outreach and education, member services, contract compliance, and reporting
  • Develop and maintain the behavioral health network and ensure that it is fully integrated with the physical health provider network
  • Identify and address potential behavioral health under- or over-utilization
  • Oversee all behavioral health community resources, including Community Mental Health Centers (CMHCs)
  • Report all MCO’s provisions of behavioral health services
  • Oversee subcontracts related to behavioral health services
  • Qualifications:

    Education/Experience: Bachelor's degree in Social services, Psychology, Health Administration, or related field. Master’s degree in a behavioral health specialty preferred. 7+ years of behavioral health experience and working knowledge of Medicare, Medicaid and health plan administration. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

    In New Hampshire only:
    8+ years of behavioral health experience. LDAC preferred.

    For Fidelis Care only:
    License/Certification: NYS unrestricted license as Licensed Clinical Social Worker (LCSW), Registered Nurse (RN), Licensed Mental Health Counselor (LMHC) or PhD

    Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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