Director Behavioral Health Strategy

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Job Information

Humana

Director, Behavioral Health Strategy

in

Newport

Rhode Island

Description

The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have access to quality care for their behavioral health needs. The Director, Behavioral Health (DBH) will report to Vice President and Chief Medical Officer but will work in close collaboration with other associates and organizations focusing on behavioral health.

Responsibilities

Key responsibilities include:

Develop strategic initiatives for overseeing clinical integrity, especially for utilization and case management activities. This includes developing measurable metrics to evaluate the success of the Behavioral Health programs.

Lead audit reviews of the behavioral health teams, participate in developing standards of care and clinical analytics, and serve as a key leader in quality improvement oversight and activities.

Represent the clinical team for NCQA initiatives related to behavioral health

Influence the strategic development, delivery, and ongoing refinement of Humana Medicaid's integrated clinical models to drive optimal provider and member experience and performance

Work collaboratively with state aligned CMOs and cross-functional corporate teams to tailor models and strategies to meet regulatory, contractual and/or local nuances related to behavioral health programs.

Key qualifications and competencies:

Master's Degree in a behavioral health related field such as social work, counseling, and/or psychology

Clinical Licensure, such as, but not limited to: Licensed Masters Social Worker (LMHC, LCSW, LMSW or LMSW-ACP), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT); RN with experience in behavioral health setting

At least 10 years' experience in fields related to behavioral health; minimum 5 years of leadership experience

Progressive experience in managed care preferably with integrated behavioral health services for Medicaid population

Participation in complex clinical case reviews and treatment; experience in working with individuals with serious mental illness and substance abuse, intellectual and developmental disabilities, and neonatal abstinence syndrome

Prior experience with oversight of UM/CM programs and development of clinical practice guidelines

Prior leadership in quality improvement activities

Strategic thinking and business planning capabilities; organized and detail-oriented

Excellent written and verbal communication skills; demonstrated presentation skills

For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

Provide proof of full vaccination, including booster or commit to testing protocols

*OR  *

Provide proof of applicable exemption including any required supporting documentation

​​Medical, religious, state and remote-only work exemptions are available.

Location:

This role is available to work remotely/at home from any U.S. location. Some travel may be required.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com