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Behavioral Health Program Specialist

2 months ago

Camarillo, California, United States Gold Coast Health Plan Full time
Job Title: Behavioral Health Program Specialist

Job Summary:

The Gold Coast Health Plan (GCHP) Behavioral Health Program Specialist plays a crucial role in supporting the development and administration of key clinical initiatives that align with the organization's strategic vision. This position is responsible for working closely with community organizations, partners, and providers to develop and implement whole person care approaches, address social determinants of health, and integrate behavioral health services.

Key Responsibilities:

  • Research and synthesize key points to facilitate understanding and action for new lines of service or incentive programs.
  • Utilize knowledge of program development and evaluation to provide management and oversight of behavioral health and social programs and their providers.
  • Coordinate data collection and reporting, and prepare program reports and documents timely.
  • Facilitate, convene, and engage stakeholders in collaborative program development.
  • Assist with new behavioral health benefit implementation.
  • Evaluate service delivery and program gaps, and develop improvement recommendations.
  • Work collaboratively with departments such as quality and population health to generate data insights for program development, management, improvement, and evaluation.
  • Assist in the development of integrated strategies to increase the delivery of coordinated, high-quality services and access to care.
  • Draft and revise policies and procedures.
  • Provide technical assistance to partners and vendors for required reporting to Department of Health Care Services.
  • Monitor performance of incentive programs and audit new benefits to ensure quality and access.
  • Provide planning and reporting support for Carelon and Ventura County Behavioral Health (VCBH), including Joint Operating Meetings, and mandates such as No Wrong Door.
  • Coordinate Performance Improvement Projects with Information Technology, Quality, delegates, and providers to ensure achieving targets for Medi-Cal Managed Care Accountability Set (MCAS) quality measures and National Council for Quality Assurance (NCQA) accreditation.
  • Ensure confidentiality of protected health information and maintain compliance with privacy laws.
  • Assist with data collection as required.
  • Prepare written reports, supporting and reporting required metrics, and other pertinent performance data, as directed.
  • Provide accurate documentation to meet departmental policies, regulatory requirements, and audits.
  • Attend meetings and conferences at local and state levels and make both written and oral presentations as necessary.
  • Adhere to all GCHP Policies and Procedures and meet required performance standards.
  • Establish and maintain effective working relationships with internal and external providers, partners, community resources, and service agencies.
  • Other duties as assigned by manager/director.

Requirements:

  • Expertise in behavioral health service delivery and program development/evaluation.
  • Ability to work collaboratively with internal departments to develop policies reflective of operational needs and in compliance with state and federal regulations, and contractual requirements.
  • Strong organizational, analytical, problem-solving, and project management skills.
  • Demonstrated ability to build strong relationships with external partners.
  • Ability to adapt to constantly changing priorities in managing various projects simultaneously.
  • Maintain a high degree of credibility, confidentiality, and integrity.
  • Work independently on assigned projects.
  • Work as a team member as department tasks dictate.
  • Prioritize tasks according to internal and external deadlines.
  • Ability to communicate research findings clearly through tables, charts, and figures.

Competency Statements:

  • Management Skills - Ability to organize and direct oneself and effectively supervise others.
  • Business Acumen - Ability to grasp and understand business concepts and issues.
  • Customer Oriented - Ability to take care of the customers' needs while following company procedures.
  • Coaching and Development - Ability to provide guidance and feedback to help others strengthen specific knowledge/skill areas.
  • Communication, Oral - Ability to communicate effectively with others using the spoken word.
  • Team Builder - Ability to convince a group of people to work toward a goal.
  • Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type.

Education and Experience:

  • Training and education or attainment of a degree in public health, healthcare administration, or related fields.
  • 2 or more years of experience in the healthcare field desired, especially program development and evaluation, health administration, or equivalent combination of education and experience.
  • Managed care experience in a health plan preferred.

Computer Skills:

  • Strong background and knowledge of computer systems.
  • Personal computer skills included in the MS Office products.
  • Data collection, analytics, and reporting.

Other Requirements:

  • Desired:
    • An attitude to excel, a special empathy for working with multiple populations, an investigative personality, and a willingness to mentor colleagues.
    • A working knowledge of Medi-Cal and related policy and regulations.
  • Required:
    • Ability to evaluate clinical and other health data and to communicate effectively both orally and in writing.
    • Ability to synthesize thoughts and plans succinctly in writing. Ability to balance multiple tasks.
    • Strong organizational skills. Critical thinking skills.
    • Flexibility in role delineation and workload assignments. Team player.