Behavioral Health Strategy Lead

Overview

Become a part of our caring community and help us put health first. The Behavioral Health Strategy Lead builds behavioral health strategies within the enterprise, business or segment to develop best practices and processes to improve outcomes for members. The Behavioral Health Strategy Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The ideal candidate will demonstrate the ability to work independently as well as collaboratively with cross-functional teams.

Note:

This position requires residence in South Carolina.

The Behavioral Health Strategy Lead is a strategic contributor responsible for the development and refinement of behavioral health programs tailored to the needs of Medicaid plan members in South Carolina. This role involves a deep understanding of quality measures and principles of behavioral health, as well as engaging with providers and stakeholders to advocate for key policies that enhance the delivery of integrated care.

The lead will collaborate closely with the Health Services Director, Chief Medical Officer, and various stakeholders to develop innovative products and services within Humana s Medicaid BH delivery model.

• Develop, implement, and refine behavioral health programs that meet the diverse needs of populations served, ensuring alignment with evidence-based practices and compliance with local and federal regulations.

• Analyze data and trends in behavioral health services to identify opportunities for program innovation and improvement.

• Understand and apply quality measures specific to behavioral health, utilizing them to inform program development and enhance outcomes for plan members.

• Collaborate with the Medical Director and Clinical Leaders to implement population health strategies that improve care delivery and member outcomes.

• Foster partnerships with healthcare providers, community organizations, and policymakers to promote a comprehensive approach to behavioral health.

• Serve as a subject matter expert on behavioral health policies, advocating for changes that support the integration of mental health and substance use disorder services within the healthcare system.

• Engage in advocacy efforts to reduce stigma around mental health issues and promote awareness of available services.

• Utilize data analytics to monitor program effectiveness, prepare reports, and communicate outcomes to leadership and stakeholders.

• Must reside in South Carolina

• An active and unrestricted Licensed Behavioral Health Professional in South Carolina, such as:

  • Licensed Clinical Social Worker (LCSW)

  • Licensed Professional Counselor (LPC)

  • Licensed Marriage and Family Therapist (LMFT)

  • Psychiatric Nurse Practitioner (PMHNP-BC)

  • Qualified Mental Health Professional (QMHP)

  • Clinical Psychologist or Psychiatrist

  • Other clinical license in behavioral health

• Minimum of five, (5) years of behavioral health practitioner experience

• Minimum of two, (2) years in a leadership role managing behavioral healthcare operations.

• Knowledge of the managed care industry and Medicaid, with familiarity in South Carolina-based behavioral health organizations.

• Proven ability to engage and collaborate with healthcare providers and community stakeholders.

• Excellent analytical and communication skills, with experience in data reporting and program evaluation.

• Experience in Medicaid Managed Care clinical or behavioral health leadership which will include hiring, training, coaching and up to termination.

• Familiarity with accreditation standards and contract requirements.

• Workstyle: remote work at home

• Location:
  
  Columbia, South Carolina

• Schedule:
  
  8:00 AM to 5:00 PM Eastern Monday through Friday

• Travel:
  Less than 25% (Travel will be mainly within South Carolina)

• Work-At-Home Requirements

• To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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…