Sr. Manager, Regulatory Behavioral Health Service & Utilization Requirements

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Position Summary

Aetna Better Health of Florida is searching for a Senior Manager of Regulatory Behavioral Health Services & Utilization Requirements with a strong understanding of the Florida behavioral health provider and services landscape with demonstrable knowledge in Medication Assisted Treatment (MAT) and Screening, Brief Intervention and Referral to Treatment (SBIRT).

You will interface with various external stakeholders including BH Associations, community-based organizations, state regulators and direct-care BH providers and must possess the people-skills and subject matter expertise to participate or drive conversations and actions in this realm.  You will be successful in this role if you successfully drive greater utilization of both SBIRT and MAT – that is, adoption by Medicaid providers to administer SBIRT and/or MAT and drive an increase in the utilization of these services by beneficiaries of the Medicaid program.  You may be tasked with driving participation in other behavioral programs as well.

This role delivers on state-defined health goals for which Aetna Better Health of Florida is responsible to achieve state-articulated targets. This is not a clinical role, nor a member-facing role, but we would welcome candidates who have clinical credentials/experience into this business role. This job requires significant travel (predominantly via car) to fulfill face-to-face meetings and events, most often in the southern half of Florida but occasionally to Tallahassee and other areas. 

 This role reports to the health plan’s Director of Behavioral Health.

Other duties include:

• Develop the strategy to achieve the necessary goals in collaboration with health plan leaders. 
• Act as a cross-functional liaison to internal stakeholders (such as our community development, network, and clinical teams) to ensure their activities also contribute to the health plan’s success in hitting state-defined goals.
• Responsible for communicating the health plan’s progress toward goals to regulators and completing the regulatory reports on which this progress is documented. 
• Create communications specific to your role, including a comprehensive training curriculum and provider toolkit designed to achieve SBIRT and MAT goals.
• Contribute to reporting data and subsequently reviewing, analyzing and presenting this data internally to ensure that we are trending towards required outcomes.
• Be a participant in the ABH-FL maternity strategy contributing to positive birth outcomes for our members through the increased use of SBIRT and MAT.

Required Qualifications

• 3+ years’ experience in a BH/Substance use or Medicaid-related field
• Demonstrable knowledge in Florida behavioral health services and BH providers.
• A strong working knowledge of MAT and SBIRT, and substance use programs.
• Strong communication skills and project management skills.
• Microsoft office suite (Word, Excel, PowerPoint etc) experience
• Must be a FLORIDA resident, located within a key area of our Medicaid Network because the successful candidates will be required to travel within regions D (Hillsborough, Polk, Manatee, Hardee, Highlands), E (Orange, Osceola, Seminole, Brevard) and I (Miami Dade and Monroe). Overall travel expectation is estimated at 75%.
• A valid Florida drivers license and automobile
• Must successfully complete a background check with fingerprinting
   

Education

Bachelor’s degree or equivalent work experi3ence

Pay Range

The typical pay range for this role is:

$67,900.00 - $149,328.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.  This position also includes an award target in the company’s equity award p