Director of Managed Care Operations

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🔥 2 hours ago

🏄 California – Remote

🏄 California – Remote

💵 $210k - $245k / year

⏰ Full Time

🔴 Lead

⚙️ Operations

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California Mental Health Services Authority

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2009

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

California Mental Health Services Authority (CalMHSA) is an independent administrative and fiscal public entity representing California counties. It focuses on transforming mental health care by developing electronic health records (EHR) and promoting interoperability among various health IT systems. CalMHSA supports counties in improving mental health services through initiatives like early psychosis intervention, workforce development, suicide prevention hotlines, and research on equity and community impact. The organization works closely with county behavioral health departments to enhance support for mental health initiatives, especially in underserved communities.

📋 Description

• Under the supervision of the Senior Director of Quality Assurance and Compliance, this position performs clinical and administrative functions that support counties in quality improvement and utilization management. • This position partners with county and contractor staff by providing training, technical assistance, and guidance to support best practices in clinical documentation, program effectiveness, continuous quality improvement, and the processes and outcomes of care. • Lead in developing quality assurance and improvement activities. • Support the development of regional compliance practices to regulatory requirements impacting counties. • Lead strategic planning and implement strategies in collaboration with management team, and other key staff members. • Perform program development and coordination work to implement and maintain a quality management program that effectively measures, assesses, and continuous improvement in the access to and quality of care/services provided to the County's mental health consumers. • Develop and lead training initiatives, including activities as a Subject Matter Expert (SME) in areas of quality assurance, policy, and compliance that comply with local, state, and federal regulations. • Apply and incorporate clinical best practices to training and county behavioral health support. • Develop and present project related documents which could include reports, contracts, agreements, presentations, and other similar materials. • Oversee and manage key contracting deliverables and key performance indicators. • Work closely with regulatory agencies that inform county behavioral health contractual agreements.

🎯 Requirements

• Master's degree with a clinical emphasis • At least 5 years of management experience • Experience leading quality improvement initiatives and developing a quality assurance program • Ability to establish and meet deadlines; beginner to intermediate project management skills for managing deadlines with small to medium teams • Ability to organize multiple streams of work effectively and multitask; attention to detail and accuracy is required • Effective written and oral communications; including an ability to synthesize information from a variety of sources • Demonstrated sense of urgency, initiative, responsiveness; proactive approach to work • Strong verbal and written interpersonal and communication skills • The ability to work well with a multidisciplinary team to develop solutions to support CalMHSA's members • Highly analytical approach to problem analysis and problem-solving with strong attention to detail and accuracy • The ability to read and understand regulatory language • Able to multi-task on several projects and collaborate with groups and partners of various technical skill levels • Able to prioritize projects and direct available resources as necessary while meeting timelines and remaining within budget • Demonstrated ability to remain current with all new regulatory standards around health information technology • Knowledge of project management principles.