Behavioral Health Director

Location: Hybrid. Most of the positions at YCCO are hybrid, meaning they have the flexibility to work both remotely and/or in-person at YCCO's office in McMinnville, OR.

Department:    Health Plan Operations                                                FLSA Status:               Exempt

Reports To:      YCCO President & Chief Executive Officer (CEO)      Physical Strength:      Light (L)

Learn more about Yamhill Community Care:  click here

About Us:  Yamhill Community Care is a nonprofit coordinated care organization dedicated to managing the healthcare for Medicaid members, covered under the Oregon Health Plan, in Yamhill County, as well as parts of Washington and Polk Counties. Our mission is to improve the quality of life of the communities we serve by coordinating effective care. Beyond healthcare, we also provide an Early Learning Hub, supporting families and children with essential resources and programs for early childhood development. Together, we're building a unified healthy community that celebrates physical, mental, emotional, spiritual, and social well-being.

Summary

This position is responsible for oversight of the administration of Behavioral Health (BH) services including but not limited to Mental Health (MH) and Substance Use Disorder (SUD) services to ensure the needs of Yamhill Community Care (YCCO) members are being met. This position is accountable for successful completion of all BH related Oregon Health Authority (OHA) deliverables and contract compliance. This position monitors the adequacy and quality of BH services available to members and collaborates to address deficiencies working to advance the integration of BH with physical and dental health by performing the following duties.

Essential Duties

1. Guides to the development and maintenance of the Behavioral Health Network ensuring access to adequate providers and services.
2. Collaborates and serves as a consultant to Medical Directors and operational leaders in the delivery of BH care coordination and utilization management services including prior authorizations. 
3. Leads quality and transformation efforts within the behavioral health delivery system including the facilitation of committees and collaboratives, project implementation, and evaluation.

Job Duties

• Leads the identification of BH initiatives, formulates strategic plans, and allocates resources to achieve organizational goals and fulfill contract obligations.
• Collaborates with clinical and operational leaders in the oversight and coordination of BH services across the continuum of care ensuring an adequate array of providers and clinically appropriate services and optimal outcomes. Leads the Behavioral Health Quality Management (BHQMC) committee.
• Works to increase access to and integration of Traditional Health Worker (THW) services within the behavioral health delivery system.
• Meets all OHA BH related deliverables and contract requirements.
• Supports the Quality and Health Equity Teams to advance the development and implementation of the System of Care.
• Provides guidance in the determination of appropriate level of care, quality of care, and explores alternative levels of care for members with BH needs.
• Works with the Clinical Operations team in reviewing complex cases and authorization requests.
• Provides BH expertise and consultation services internally to improve member engagement and the effectiveness of the Clinical Operations, Quality and Health Equity, and Pharmacy departments.
• Works in collaboration with internal and external partners in the development of strategies to improve the health outcomes of members with severe and persistent mental illness, substance use disorders, and members with comorbid BH and complex chronic conditions.
• Contributes to the development of BH integration, including THWs, and drives implementation of strategies to achieve integration in collaboration with community partners.
• Develops and facilitates communication with community partners and Clinical Operations focused on preventing avoidable hospitalization, thus avoiding costs and risks encountered in institutional settings.
• Collaborates with other departments and community partners to improve communication and care processes.
• Leads process improvement projects aimed at improving the delivery of BH services.
• Develops and maintains department policies, operating procedures, and materials aligned with state, federal and contractual requirements for the delivery of behavioral health services.
• Represents YCCO at appropriate OHA and community meetings.

Management & Leadership

• Ensures program expectations and standards are clearly understood by department staff.
• Provides staff with the training, tools, and resources necessary to carry out their work.
• Analyzes staff productivity and quality, reorganizing and distributing work assignments needed.
• Supervises assigned department staff in a consistent manner.
• Evaluates department employees’ performance both informally and formally and takes corrective action to address areas of opportunity.
• Performs human resource functions in collaboration with Human Resources department.

Essential Department & Organizational Functions

• Works to cultivate and develop inclusive and equitable services, and working relationships with diverse groups of employees, community partners, and community members.
• Participates in the preparation and submission of regulatory and contract required deliverables.
• Works closely with other YCCO departments, including Health Plan Operations and Compliance to assist with audits; including the External Quality Review (EQR), as needed.
• Proposes and implements process improvements.
• Meets deadlines for completion of assigned responsibilities and projects.
• Maintains agreed upon work schedule with punctual, regular, and predictable attendance.
• Attends in person Annual Company Conference in Oregon; typically held in the fourth week of September.
• Demonstrates cooperation and teamwork using a professional and respectful demeanor.
• Provides cross-training on specific job responsibilities.
• Meets identified goals that contribute to departmental goals.
• Works collaboratively in a team and matrixed (cross-department) environment with a spirit of cooperation.
• Respectfully takes direction from Supervisor.
• Performs other duties as assigned.

Knowledge, Skills, & Abilities

• Demonstrated depth of experience in building relationships with Coordinated Care Organizations (CCO), Oregon Health Authority, providers and community stakeholders.
• Results-oriented with a high attention to detail. Ability to manage multiple priorities, and meet deadlines in a demanding, fast-paced environment.
• Solid knowledge of health plan finance and the compensation arrangements between health plans and providers.
• Program management, presentation, and reporting responsibility.
• Broad experience with a corporate matrix environment, with regular interface, centralized and field-based operational and business development functions (finance, network, contracting, medical management, sales and customer service).
• Experience as an influential communicator and creative problem solver, with successful examples of partnering across functions to gain consensus and support for new initiatives and programs.
• Ability to demonstrate critical thinking, analytical and problem-solving skills.
• Skilled in driving results, thinking strategically, and executing strategy effectively.
• Ability to contribute to a strong team-based environment.
• Ability to build and maintain professional relationships with community stakeholders.
• Ability to work independently, use sound judgment, anticipate next steps and be proactive as part of a diverse team within a Matrix or shared resources across departments work model.
• Ability to work independently, use sound judgment, anticipate next steps and be proactive as part of a diverse team within a Matrix or shared resources across departments work model.
• Excellent computer skills, including Microsoft Windows, Word, Excel, and Outlook.
• Ability to communicate both professionally and effectively in all forms of communication.
• Ability to work in an environment with diverse individuals and groups.
• Ability to remain flexible, positive, and adaptable.
• Ability to work across the YCCO region and to work remotely, as needed. 
• Excellent organizational skills including ability to handle multiple priorities and demands simultaneously in a dynamic work environment while maintaining high attention to detail and accuracy.

Supervisory Responsibilities

Directly supervises employees in the Health Plan Operations Department – Behavioral Health Team. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Qualifications

Ability to perform essential job duties with or without reasonable accommodation and without posing a direct threat to safety or health of employee or others. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation(s) may be made to enable individuals with disabilities to perform the essential duties.

Education & Experience

Required:

• Master’s in Behavioral Health or other Health Services related degree, 

     AND:

• Minimum ten (10) years’ related experience as a leader in a clinical behavioral health or health plan setting, or any work experience and/or training that would likely provide the ability to perform the essential position functions. 

     OR:

• Any combination of education and experience that would qualify candidate for the position.

Preferred:

• Eight (8 ) years’ experience supervising or leading a Healthcare team.
• Experienced in integrated health systems.
• Experience with CCO and Medicaid and Dual Eligible managed care.

Certificates, Licenses and/or Registrations

Required – any of the following:

• Licensed Clinical Social Worker (LCSW),
• Licensed Master of Social Worker (LMSW),
• Licensed Professional Counselor (LPC),

     OR:

• Equivalent license. 

Physical Demands & Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this position. The work environment characteristics described here are representative of those an employee encounters while performing the essential duties of this position. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential duties.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit, stand, walk, use hands and fingers, handle or feel, and reach with hands and arms. The employee is occasionally required to climb or balance, stoop, kneel, crouch or crawl. The employee may occasionally need to lift and/or move up to 25 pounds.

This position operates in a professional office environment and requires frequent use of standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Specific vision abilities required by this job include close vision, color vision, distance vision, depth perception, and ability to adjust focus. The noise level in the work environment is usually moderate.

This position may include occasional required or optional travel outside of the workplace, in which the employee’s personal vehicle, local transit, or other means of transportation may be used.