Planning and Operations Manager - Behavioral Health

at  CareOregon

CANDIDATES HIRED FOR REMOTE POSITIONS MUST RESIDE IN OREGON, WASHINGTON, UTAH, IDAHO, ARIZONA, NEVADA, TEXAS, MONTANA, OR WISCONSIN.

Job Title
Planning and Operations Manager – Behavioral Health
Exemption Status
Exempt
Management Level
Manager
Direct Reports
Operations Team
Manager Title
Director, Behavioral Health Operations
Department
Behavioral Health
Pay and Benefits
Estimated hiring range $98,390 - $120,250 / year, 5% bonus target, full benefits. www.careoregon.org/about-us/careers/benefits
Posting Notes
This is a fully remote role but you must reside in one of the listed 9 states.

JOB SUMMARY

The Planning and Operations Manager – Behavioral Health is responsible for monitoring and leading the advancement of behavioral health strategies, projects, initiatives and operations for either CCOs or BH Department across the department and lines of business. This includes assisting with strategic deployment and operational implementation of priorities impacting Behavioral Health within CareOregon and supervises staff.

EXPERIENCE AND/OR EDUCATION

Required

• Minimum 5 years’ experience in a health care setting, including a minimum of:

o 2 years’ experience in a Medicare and/or Medicaid health plan setting

o 2 years’ experience in quality, compliance, and/or operations work

• Master’s degree in health care related field

Preferred

• Certification in Healthcare Quality (CPHQ) or Healthcare Compliance (CHC)
• Work experience in a behavioral health system of care and/or administering Medicaid/Medicare behavioral health benefits
• Minimum 2 years’ experience in a supervisory position or minimum 1 year experience in a supervisory position with completion of CareOregon’s Aspiring Leaders Program

Knowledge, Skills and Abilities Required

Knowledge

• Knowledge of federal, state and national BH compliance/quality assurance regulations related to Medicaid
• Knowledge of CMS Health Plan compliance requirements as well as provider compliance requirements and ability to operationalize or provide technical assistance to other entity.
• Knowledge of managed health care requirements and ability to operationalize within the BH sector
• Knowledge and experience with developing and implementing a quality and compliance monitoring program of a provider network
• Knowledge of health care databases and functionality

Skills and Abilities

• Ability to remain abreast of BH operations policies and standards
• Ability to research, understand, interpret and communicate federal and state requirements, including the Code of Federal Regulations, Oregon Revised Statutes and Administrative Rules
• Ability to perform all aspects of auditing (e.g., objectives, methodology, sampling, testing)
• Ability to prepare clear, concise and objective audit reports with recommendations for improvement
• Competency with computer software programs, e.g. MS Outlook, Word, Excel, and PowerPoint
• Ability to define reporting requirements and work with developers to create needed reports
• Ability to analyze and create strategies based on data/reports
• Excellent customer service, engagement, and partnership skills, including written and verbal communication with a broad array of stakeholders
• Comfort in providing presentations of data and complex processes
• High degree of initiative and motivation along with the ability to effectively collaborate and plan with coworkers and others
• Ability to set goals independently and prioritize work to balance competing deadlines in a professional manner, while managing multiple tasks
• Ability to work in an environment with diverse individuals and groups
• Ability to retain and maintain confidential files
• Ability to work effectively with diverse individuals and groups
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
• Ability to hear and speak clearly for at least 3-6 hours/day

ESSENTIAL RESPONSIBILITIES

Projects and Planning

• In partnership with senior leadership and quality team, manage and the CCO or BH Department portfolio of behavioral health projects and performance dashboard.
• Lead and participate in developing, implementing and monitoring clinical and operational strategy aligned with the organization at large and each line of business.
• Identify and lead a process for developing and administering the team’s annual strategic plan, as well as underlying goals, projects, strategies and metrics; influence and negotiate for necessary resources and timelines as needed.
• Develop and lead a monitoring system with visibility to department and Senior Executive Leadership of progress toward goals with specific metrics.
• Liaise with Population Health to collaborate on cost and utilization planning and deliverables.
• Perform project management for Behavioral Health initiatives across the line of business and internal to the department.
• Ensure stakeholder engagement to move strategies forward within CO and the line of business.
• Ensure standard and specialized tools and processes are developed, deployed and improved upon regularly to support the various project and programs.

Regulatory and Operations

• Inform, develop and lead the operational infrastructure to ensure the Behavioral Health CCOs are operating as efficiently as possible and delivering the highest quality services to its customers (LOBs, network, and staff).
• Ensure staff understand the overall clinical and operational strategy and their role in supporting this work.
• Guide team in working effectively across departments and lines of business within the matrix.
• Develop communication plans to ensure internal and external stakeholders are informed and aligned to support the execution of clinical initiatives; this includes working cross-departmentally with other departments.
• Oversee and manage CCO or BH Department meeting infrastructure, including central tracking and communication systems.
• Ensure performance measurement reports are incorporated into departmental tracking; prepare regular reports, as well as updates on trends or areas of concern for internal CareOregon leadership.
• Ensure that regulatory requirements are tracked and incorporated into the Behavioral Health department’s compliance and oversight framework and project plans.
• Assist in staffing senior leadership meetings and huddles; attend and participate in meetings on behalf of the CCO Behavioral Health Director or BH Department VP.
• Organize and manage activities such as retreats, team development, and other forums to ensure collaboration and cohesion.
• In partnership with department leadership, identify content and presentations for CareOregon All Staff meetings.
• Collaborate with data analysts to extract and present relevant data internally and externally.
• Analyze and recommend areas for improvement in working effectively across departments and lines of business within the matrix structure.
• Assist department leaders in documenting and overseeing existing policies and procedures.
• Oversee the creating of, or improvement upon, policies and procedures to improve network oversight for high quality care and compliance with contractual and accreditation requirements from multiple sources.
• Oversee the coordination of activities related to External Quality Review audits in collaboration with CareOregon’s Legal Affairs division.

Employee Supervision

• Manages a team and recommends team direction and goals in alignment with the organizational mission, vision, and values.
• Identify work and staffing needs to meet work expectations; recruit and hire, using an equity, diversity, and inclusion lens.
• Plan, organize, schedule, and monitor work; ensure employees have information and resources to meet job expectations.
• Lead the development, communication, and oversight of team and individual goals; ensure goals, expectations, and standards are clearly understood by staff.
• Train, supervise, motivate, and coach employees; provide support toward employee development.
• Incorporate guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, and decision making.
• Ensure team adheres to department and organizational standards, policies, and procedures.
• Evaluate employee performance and provide regular feedback to support success; recognize strong performance and address performance gaps and accountability (corrective action).
• Perform supervisory tasks in collaboration with Human Resources as needed.

ORGANIZATIONAL RESPONSIBILITIES

• Perform work in alignment with the organization’s mission, vision and values.
• Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
• Strive to meet annual business goals in support of the organization’s strategic goals.
• Adhere to the organization’s policies, procedures and other relevant compliance needs.
• Perform other duties as needed.