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Extra Help - Behavioral Health Services Director (Y010) - Eugene, OR

Company: Lane County Gov
Job type: full-time
Category: Hospital, Health Care

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Job description

Job Description:

Description Lane County Health and Human Services Trillium Behavioral Health Is currently recruiting for Extra Help Behavioral Health Services Director (10-20 hours per week) Psychologist Licensure - $40.00 - $50.00 / hour Psychiatrist Licensure - $90.00 - $110.00 / hour Trillium Behavioral Health manages the behavioral health benefit for Trillium Community Health Plan (the CCO) and supports contractors to provide a range of mental health services in Lane County. Behavioral Health Services Director will provide vision, leadership and clinical and professional support to Trillium Behavioral Health (TBH) program. The Behavioral Health Services Director is responsible for meeting NCQA and CMS requirements and reviewing denials and specialty care authorizations. Primary Responsibilities and Duties: * Provide vision, leadership, and clinical guidance for TBH program to ensure program operates efficiently and effectively and meets regulatory requirements and organizational goals related to denials and specialty care authorizations. * Exercise sound clinical judgment in decision making such as establishing criteria for authorization and review, medical necessity, benefit exceptions, and new technologies. * Collaborates with the Quality Management and Improvement (QMI) team and participates in QMI-related committees and activities, ensuring QMI activities are consistent with behavioral health care standards and clinical appropriateness. * Develop, update, implement and interpret utilization management (UM) policies and procedures and clinical guidelines to guide and support the provision of coordinated and cost-effective behavioral health care. Education/Certification/Licensure: * Doctor of Psychology degree from an accredited APA program (PhD) or an MD (Psychiatry preferred) is required. * Board certification in a specialty recognized by the American Board of Medical Specialties or the American Board of Professional Psychology is required. Re-certification as required by specialty board must be maintained. * An unrestricted and current Oregon license in good standing to practice psychology or medicine (psychiatry preferred). Experience: * Direct patient care serving populations with chronic health care conditions, co-occurring medical and behavioral health disorders and physical and/or intellectual disabilities is required; 5-10 years clinical experience is preferred. * Health insurance business functions including commercial products, Medicare, Medicaid (including the Oregon Health Plan). * Clinical oversight of behavioral health plan services * Development of Quality Improvement Plan and monitoring for continuing improvement of utilization management programs. * Meeting health plan regulatory and accreditation requirements. Skills: * Excellent interpersonal communication with members and families, providers, community partners, and co-workers at all levels of the organization. * Recognize and analyze problems, cultivate alternative solutions, vet alternatives, formulate plans, and implement actions. * Strong applied clinical judgment and critical thinking skills. * Be both an effective team member and team leader. * Clear understanding of health plan regulatory systems, processes, and operational components, with emphasis on management of health services within an integrated managed care model. * Proficiency with Microsoft Product Suite. Schedule: Hours will vary depending on program needs. *This position is budgeted for a maximum of 520 hours during the fiscal year beginning July 1, 2016 and ending June 30, 2017. *This position is non-represented* This position is subject to a full criminal offender information record check. If fingerprinting is required, the fee is paid for by the successful candidate and the expense is non-reimbursable. Offers of employment are contingent upon consenting to and successfully passing a drug screening test, negative results are reimbursable. Lane County complies with the Americans with Disabilities Amendments Act of 2008. If you require reasonable accommodation in the application and/or interview process due to disability, requests must be made in a timely manner. Contact a recruitment specialist at .

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