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J201975

Director Enterprise Behavioral Health Clinical Programs and Innovation

Highmark Health

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

Company :

Highmark Health

Job Description : 

JOB SUMMARY

Are you a behavioral health professional with clinical leadership experience in evidence-based treatment and passionate about transforming and innovating behavioral health care at scale? Highmark Health, one of the nation’s largest payor and provider health systems, is recruiting for an enterprise-level director to lead the clinical design and implementation of behavioral health innovations, programs, and policies central to transforming behavioral health care delivery. Reporting to the Executive Medical Director, Behavioral Health, this position will manage a portfolio of initiatives to drive clinical innovations and digital behavioral health interventions and related solutions across Highmark’s health plan and provider delivery system (Allegheny Health Network) regionally and nationally. The position will oversee development of clinical content and processes for digital solutions and innovative identification and outreach functions and initiatives (e.g., digital phenotyping, ID & stratification) designed to personalize treatment and move behavioral health care and support upstream. The position will be responsible for alignment and integration of clinical, operational, and technological functions into the overall enterprise mission.

Highmark Health is a national, blended health organization that includes one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network with annual revenues of over $18 billion. The enterprise serves 5.6 million members nationwide and employs 35,000 employees. 

Remote/virtual work opportunities will be considered.


ESSENTIAL RESPONSIBILITIES

  • Perform management responsibilities to include, but arenot 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.
  • Direct programs and initiatives related to Behavioral Health clinical innovations and digital solutions; lead clinical development/curation of digital BH applications and training; lead digital solution integration into clinical workflows; coordinate integration of behavioral motivation principles into non-BH digital solutions for promoting engagement, adherence, and health behavior change; direct clinical development of the BH Hub platform, features, and personalization/triage function.
  • Direct clinical development and execution of identification and outreach initiatives (e.g., digital phenotyping, ID and strat); provide training to and interface with clinical team leaders on the ground; coordinate communications and outreach to providers, patients, members. 
  • Direct processes for evaluation of clinical innovations and digital solutions, 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,  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.
  • Develop effective internal and external partnerships that support business initiatives and growth that further opportunities for clinical integration with other health care providers such as physician networks and other solution partners.
  • 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.  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. Oversee the development of outcomes measurement and reporting, identification and stratification of members, and develops clinical tools for clinicians to deliver programs. Use performance measurement to continuously improve programs.
  • Maintain a working knowledge of project related Medicare regulations to ensure the organization meets compliance standards, accreditation  standards to ensure the organization meets standards to ensure a constant state of audit readiness.
  • Other duties as assigned or requested.


EDUCATION


Required

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

Substitutions

  • None


Preferred

  • None

EXPERIENCE

Required

  • 10 years in Healthcare or related field
  • 5 years in a Program/Project Management role with significant scope and impact
  • 5 years in a management or leadership role

Preferred

  • Experience in a comparable management role in a health-related setting
  • Prior responsibility for budget adherence, project schedule adherence and/or fulfilling other key success metrics within corporate environment
  • Strong background in evidence-based behavioral health treatments for anxiety, substance use disorders, and/or other behavioral health conditions.
  • Significant familiarity with digital behavioral health solutions and other clinical innovations.


LICENSES or CERTIFICATIONS


Required

  • Professional license in Psychology, Psychiatry, Clinical Social Work, Psychiatric Nursing, Counseling, Marriage and 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

Office-based

Teaches / trains others regularly

Occasionally

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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