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Director of Care Coordination
3 months ago
We are searching for a Director of Care Coordination for our Behavioral Health program - someone who works well in a fast-paced setting. In this position, you'll develop and oversee a comprehensive Behavioral Health (BH) population health and/or case management strategy to improve the health and wellness of members, psychosocial, environmental, and financial. Defines population health and/or care coordination initiatives and create a structured, scalable approach to prioritizing and monitoring population health and/or care coordination initiatives, including identifying opportunities for financial savings, driving quality improvement and ensuring compliance with regulatory requirements.
Think you got what it takes?
Qualifications & Skills
- Master's degree in Social Work required
- LCSW- Lic-Clinical Social Worker - Texas Behavioral Health Ex Counc (TBHEC) required
- 5 years Supervisory/formal leadership experience required
- 3 years of Managed Care experience required
- 7 years' Experience in behavioral health required
- Understanding of managed care; preferably experience with Texas Medicaid
- Experience with public health, including public health promotion and intervention strategies and social determinant of health needs
- Experience leading, or working closely on, clinical and quality projects to completion
- Ability to synthesize data and perform ad-hoc data analysis
- Must be able to work under deadlines and closely with others continuously throughout the day
- Create and manage a population health and/or case management strategy by identifying and addressing specific needs of members including environmental, psychosocial, and financial. Integrate population health and/or care coordination principles and evidence-based research to develop interventions.
- Develop new, and enhances existing, interventions to improve HEDIS metrics, clinical outcomes, and reduce cost.
- Ensure comprehensive measurement strategy and regular reporting for population health and/or care coordination initiatives.
- Sponsor and champion MCO and system-wide initiatives to improve member wellness, including cultivating support necessary to achieve desired objectives for each initiative.
- Develops approaches, policies and programs for case management which are based on the TCH goals and objectives and which meet the TCHP performance goals.
- Maintains current knowledge and contacts with alternate sites for appropriate health care delivery within the community and the state needed for pediatric population.
- Monitors and evaluates new community resources on an ongoing basis to continue to meet the identified needs of TCHP members.
- Conducts cost/benefit analysis functions as indicated or evaluation of different modes of member engagement. Assesses resource utilization and cost management comparing the PMPM to pre and post social case management intervention. Have direct supervision of team of clinical and non-clinical staff members.
- Create and maintain tools to monitor employee productivity and progress. Establish key performance indicators. Track progress and ensure goals are achieved.
- Collaborate effectively with Executive leadership and other leaders of the Texas Children's system. Utilize presentation skills to demonstrate need and propose solutions.
- Help create and maintain a health plan-wide Behavioral Health Program that addresses BH strategy, programs, and addresses population health issues in mental health and substance use disorders
- Develop 2-3 BH specific disease management programs that meet the state and NCQA requirements for a DM Program
- Oversee the staff and the day-to-day execution of the DM program
About Us
Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.
Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
