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J187415

Director Enterprise Behavioral Health Clinical Quality and Engagement

Highmark Health

  • Company Hignmark Health
  • Home, PA
  • Clinical Services
  • Full time
  • Day (United States of America)

Company :

Highmark Health

Job Description : 

JOB SUMMARY

This job is responsible to develop and implement Enterprise Behavioral Health policies and programs designed to advance high quality, evidence-based behavioral health treatment to include: lead and coordinate clinical design, development, and evaluation of provider competency-based training programs in evidence-based psychotherapies as part of the establishment of a Center of Excellence in Evidence-Based Psychological Treatments; provide clinical input into design of innovative payment models and other incentives; develop and implement programs to promote patient, member, and provider/employee engagement; develop and oversee clinical and non-clinical programs for promoting lower-intensity interventions and upstream approaches. Responsible for alignment and integration of clinical, operational and technological functions into the overall enterprise mission.        

ESSENTIAL RESPONSIBILITIES

  • Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.  Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
  • Collaborate across the enterprise to identify programs that align with the mission to improve care and improve patient experience/outcomes while reducing the overall cost of care. Direct development and implementation of programs designed to advance high quality, evidence-based behavioral health treatment; lead and coordinate clinical design, development, and evaluation of provider competency-based training programs in evidence-based psychotherapies; provide clinical expertise to inform identification and design of innovative payment models (e.g., value-based reimbursement, pay-for-performance) and other incentives to promote and sustain high quality, evidence-based treatments; provide training to and interface with clinical team leaders on the ground.
  • Direct development and implementation of programs to promote patient, member, and provider/employee engagement; lead clinical content development of programs and innovative approaches for promoting direct-to-consumer outreach and engagement campaigns and anti-stigma messaging and training; lead development, implementation, and oversight of Behavioral Health Coach role as part of advancing and maximizing the potential of lower intensity interventions and promoting engagement. Direct development of clinical content, programs, and training for promoting employee wellness and for advancing understanding of behavioral health for employees and their teams and subordinates. 
  • Direct the use of benchmarking through scientific research, networking and literature searches to identify evidence-based and best practices as well as continuously raise the expectations of performance and remain competitive with the product offerings of other health plans and care management vendors.
  • Direct processes for evaluation, including evaluation of clinical and health outcomes, engagement, and return on investment, and processes for continuous improvement.
  • Lead and collaborate closely with key partners across the enterprise including Clinical Care and Wellness teams, Utilization Management, Workforce Management, Clinical Services, Quality, Safety, & Value, Pharmacy, Medical Directors, Business Process Engineers, Project Management, Training, IT, Care Delivery Integration, Product and Health Experience, Analytics, Reporting, Sales, Marketing,  Finance and provider partners, to design new and enhance existing programs. Collaborate extensively with market leaders, product, sales and other key areas to develop and implement solutions for emerging market and client needs including the requirements of CMS. Represent the organization on selected agency committees as requested.
  • Develop quality metrics and education initiatives for pilots and strategies that improve and challenge our current delivery model and addresses challenges in hand-offs during transitions of care, safety and appropriate levels of care.
  • Other duties as assigned or requested.


EDUCATION


Required

  • Master's Degree in Social Work, Nursing, Mental Health Counseling, or Marriage and Family Therapy, or other related discipline OR
  • Doctorate in Psychology or Psychiatry


Substitutions

  • None

Preferred

  • None


EXPERIENCE

Required

  • 7 years in Healthcare or related field
  • 5 years in a management or leadership role


Preferred

  • Experience with evidence-based psychological treatments and/or behavioral health coaching
  • Experience in a comparable management role in a health-related setting
  • Medicare, Medicaid or Commercial Lines of Business experience


LICENSES or CERTIFICATIONS


Required

  • Professional license in Psychology, Psychiatry, Clinical Social Work, Psychiatric Nursing, Counseling, Marriage & Family Therapy or related field.


Preferred

  • None


SKILLS

  • Highly motivated with exceptional organizational skills, including the ability to effectively and competently handle multiple responsibilities simultaneously and the flexibility and ability to quickly adapt to changes in work objectives, promotions, and available technology. 
  • Independently and in a team, be able to identify the root issues and formulate potential solutions and/or goal-oriented action plans in a professional environment.
  • Successfully partners through collaboration and sense of urgency regarding process implementation and improvement/optimization.
  • Exceptional writing skills, including ability to communicate and articulate strategic ideas, solutions, and clinical concepts.
  • Outstanding oral communication and  interpersonal  skills
  • Strong leadership skills and ability to work at all levels within organization
  • Strong analytic skills and business acumen
  • Impact-focused and results-oriented
  • Ability to build and foster strong culture of collaboration and teamwork


Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Remote/Hybrid

Teaches / trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.


As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice


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