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021350 Clin Alli-Care Delivery Administration

Position Summary:

The Director, Behavioral Health Care Delivery is responsible for the strategy and leadership of CCA’s over all Behavioral Health Care Delivery Program, including licensed behavioral health clinicians and health outreach workers in all CCA Care Delivery programs with BH components.The Director will collaborate closely with the Care Delivery Leadership to oversee, develop and coordinate integration of BH and SUD services across Care Delivery Programs. The Director is accountable for the clinical outcomes delivered by Behavioral Health staff in CCA Care Delivery Programs

The Director provides leadership, to clinicians, contracted employees and partners regarding behavioral health/substance abuse treatment and management and is responsible for ensuring that the facilities and models can appropriately and effectively support the needs of members with mental illness and other complex behavioral health and social needs.The Director promotes and implements best practices for integrated behavioral health and primary care.The Director also provides leadership support to Marie’s Place, and other CCA Care Delivery Assets, as needed.

The Director is responsible for promoting high standards of integrated behavioral health care delivery and care management practice through leading the development and implementation of policies, protocols, behavioral health practice and business guidelines, professional development programs, organizational development activities, performance measures and behavioral health programs across Care Delivery.

This Director, Behavioral Health Care Delivery fosters effective population health management, positive member experiences, and clinical activities that will result in positive outcomes for vulnerable populations. This position with report directly to the SVP of Integrative Program Development and Clinical Innovation with a matrix reporting to the VP of Operations.

Supervision Exercised:

• Yes, which includes but is not limited to providing leadership, work direction, and performance feedback to subordinate staff.

Essential Duties & Responsibilities:

• Supports BH care management and BH quality performance for all the CCA Care Delivery Programs

• Directs the personnel management activities of assigned areas.Responsible for, hiring, and onboarding of staff as well as performance appraisal, documentation of deficiencies, performance recognition, and disciplinary action. Develops, supervises, and appraises direct reports; plans and implements disciplinary actions as needed, works with Human Resources and legal staff as appropriate; when warranted, makes recommendations to the Senior Vice President, Integrative Program Development and Clinical Innovation

regarding the evaluation, promotion, transfer or discipline of personnel.

• Provides leadership of care plan development, clinical modeling, initial and ongoing member assessment, group structure and education in the CCA Care Delivery.

• Participates in the development and leads CCA Care Delivery Implementation of the Behavioral Health staffing plan, strategies, and operational plans to ensure high quality, consistent delivery of care management functions

• Using evidence supports BH / Clinical Vice Presidents/Medical Directors in identifying opportunities to develop, implement and evaluate interventions to improve process and workflow efficiency, staff productivity and cost effectiveness for Care Delivery .

• Oversees Behavioral Health clinical education, training and staff development for CCA Care Delivery. When indicated, facilitates internal and external stakeholder collaboration for successful programing.

• Budgetary leadership and recommendations for the Engagements Centers and Marie’s Place reporting ultimately to the SVP of Integrative Prog. Dev. and Clinical Innovation ,

• In close collaboration with Care Delivery Leadership and CCA leads continuous development of policies, protocols, practice guidelines, aligned business practices, staff development, organizational development activities, and clinical programs for CCA Behavioral Health Care Delivery

• Maintains clinical practice, providing episodic direct care to members with complex needs to patients of CCA Care Delivery..

• Ensures end to end compliance with all regulatory/contractual obligations related to care management on the Engagement Centers and CCA Behavioral Health Care Delivery, in close collaboration with Clinical Vice Presidents/Medical Directors and the Vice President, Regulatory Affairs and Compliance

• Participates in senior-level strategic planning activities, ensures that initiatives are in alignment with CCA’s global strategic plan.

• Key contributor in ensuring a value based approach to care delivery and care management that connects members to meaningful services

• Attends external meetings and activities as a representative of the organization as requested

• Seeks to maintain a constructive work environment and maintains effective communication with other employees and managers

• Leads team meetings and social / teambuilding events

• Contributes to a continuous learning culture

• Oversight of quality metrics for CCA Behavioral Health Care Delivery

• Key contributor in ensuring development of innovative models, partnerships and community partners.

• Scanning the internal and external environment, he/she will identify areas of opportunity for CCA to expand its behavioral health services so it can continue as an innovative leader in behavioral health care delivery for complex populations

• Support teams and track Key Performance Indicators (KPI) related to clinical care for members via telehealth technologies (video, chat, etc.) for a clinically appropriate clinical care and care management services.

• Work with state agencies, vendors and providers across the continuum of care to coordinate and collaborate on provision of services for Care Delivery Patients

• Work collaboratively with Health Plan partners to continue to assess CCA member needs and create innovative programs in response.

Secondary responsibilities:

• Work with clinical leadership to develop enhanced enrollment strategy for SCO and One Care membership through the participation in the Engagement Center

• Collaborate with clinical leadership to develop strategy for integration with CCA Primary Care as well as Partners in the community.

Working Conditions:

• Standard office conditions, frequent travel to external meetings and clinical sites in around Massachusetts.

Required Education (must have):

• Master’s or Doctorate degree in Social Work or Psychology

Required Licensing (must have):

• Active Massachusetts LMHC or LICSW license in good standing.

Required Experience (must have):

• 8+ years of direct experience in a healthcare or health plan environment, managed care preferred, with at least 6 years of experience in a leadership role or an equivalent

• Significant care management experience within a community health plan context preferred

• Demonstrated success in working in a collaborative manner at all levels of an organization to achieve outcomes that require building consensus and expedited implementation.

• Clinical experience managing populations with significant medical, social and behavioral health complexity

Required Knowledge, Skills & Abilities (must have):

• Demonstrated expertise in building and overseeing behavioral health education programs

• Success in developing high performing teams and building a culture of inclusion and diversity

• Proven skills, knowledge base, and judgment necessary for independent operational decision making

• Knowledge of and experience with managed care organizations, areas of expertise and approaches

• Demonstrated commitment to and interest in improving health outcomes among marginalized and underserved populations

• Knowledge of BH & SUD care delivery systems and levels of care across the state.

• Proven ability to work independently as a self-starter, to identify key tasks needed to accomplish project objectives, facilitate issue identification, problem-solving and decision-making

• Excellent organizational, time-management and problem-solving skills

• Excellent leadership skills

• Ability to function effectively as part of a multi-disciplinary team

• Curiosity and creativity

• Effective oral and written skills

• Strong interpersonal skills

• Strong attention to detail

• Able to support teams with utilization of telehealth technologies (video, chat, etc.), when appropriate, as an approved modality for a variety of clinical care and care management services

Required Language (must have):

• English

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.