Become a part of our caring community and help us put health first
 

The Director, Behavioral Health Strategy builds behavioral health strategies within Humana Healthy Horizons in Ohio Medicaid as well as the Medicaid segment to develop best practices and processes to improve outcomes for members. The Director, Behavioral Health Strategy requires an in-depth understanding of how organization capabilities interrelate across the function or segment. This position provides oversight and guidance of daily activities of BH services, ensures access to BH services, develops and promotes BH prevention strategies.

We are seeking a dynamic and strategic leader to join our team in Ohio! The Behavioral Health Strategy Lead will oversee the behavioral health (BH) clinical program for Ohio’s Medicaid plan enrollees. They will collaborate closely with Clinical and Operational Leaders to integrate the day-to-day administration and strategic management and integration of behavioral and physical health services, including utilization management and care management, while providing subject matter expertise to quality improvement initiatives, population health initiatives, and value-based payment programs. They will be a liaison and partner to provider and member services within Ohio Medicaid as it relates to behavioral health. This position is an individual contributor aligned to the Chief Medical Officer. The scope of works includes, but is not limited, to the following:

• Providing daily operational activities of behavioral health services across the full spectrum of care to members, inclusive of mental health and substance abuse services;
• Ensuring access to behavioral health services;
• Ensuring systematic screening for behavioral health related disorders by utilizing standardized and evidence-based approaches;
• Promoting preventive behavioral health strategies;
• Identifying and coordinating assistance for member needs specific to behavioral health;
• Participating in management and program improvement activities with other key staff (including the Behavioral Health Clinical Director) for enhanced integration with primary care and coordination of behavioral health services and achievement of outcomes
• Working with the Behavioral Health Clinical Director as needed in the development and maintenance of programs and systems
• Collaborates with Clinical Leaders to implement medical policy and population health strategies that advance outcomes for plan members.

Use your skills to make an impact
 

Required Qualifications

• Clinical Health Licensure- Current and unrestricted Ohio license to provide behavioral health services in the state of Ohio (Registered Nurse with Advance Practice Registered Nurse [APRN] licensure, Psychologist, Licensed Independent Social Worker [LISW], Professional Clinical counselor [PCC], Independent Marriage and Family Therapist)
• Minimum 5+ years of leadership experience in the management of behavioral health programs, behavioral health program and policy development or experience in the provision and supervision of treatment services for mental illness and substance use disorders.
• 2+ years of management/leadership in behavioral health or substance use disorders
• Knowledge and understanding of Ohio's overall behavioral health system that includes mental health, alcohol and drug addiction, and developmental disabilities services.
• Must reside in the State of Ohio or in a neighboring state with a reasonable commuting distance to travel within the State of Ohio.
• Master's degree

Preferred Qualifications

• Prior experience with Medicaid recipients including TANF, Dual eligible, foster care, and enrollees with special health care needs. Experience working knowledge of CMS guidelines 
• Experience with medical necessity criteria such as MCG and ASAM
• Health Plan experience
• Medicaid experience

Additional Information

• This is remote position with approximately 10% of your time spent in person at State meetings or within an office for required meetings.

 

WAH Internet Statement

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office e