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Wellcare

Behavioral Health Program Manager

Wellcare - Chicago, IL

Behavioral Health Program Manager','1705222','!*!About WellCare: WellCare Health Plans, Inc. is a Fortune 500 company traded on the New York Stock Exchange (symbol: WCG). It provides managed care services targeted to government-sponsored health care programs, including Medicaid, Medicare, Prescription Drug Plans and the Health Insurance Marketplace. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind and disabled. The company serves approximately 4 million members and employs approximately 6,500 people nationwide as of Sept. 30, 2014. For more information about WellCare, please visit our website at www.wellcare.com or view our videos at https://www.youtube.com/user/WellCareHealthPlan.EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, sex, age forty (40) and over, disability, veteran status, or national origin.','!*!Interacts extensively with the behavioral health leadership and cross functional associates within the organization to develop and implement long range behavioral health program strategies. Serves as project manager for projects and initiatives around integration both internally with associates and externally with providers. Directs and facilitates behavioral health clinical training programs for associates, and external behavioral/ medical provider community. Assists with BH program and services development of policy and procedure, clinical criteria, work flows and other behavioral health documentation and product development activities.

DEPARTMENT:  Health Services-BH

REPORTS TO:  Director, State Behavioral HealthEssential Functions:

Project leads behavioral health and/or behavioral health home program development and integration activities both internally and externally.

Improves quality of behavioral health product by driving cross functional initiatives.

Utilizes data to identify and manage change necessary to achieve performance improvement.

Communicates and educates associates on behavioral health strategy.

Develops behavioral health clinical educational materials, and performs provider behavioral health education.

Works to develop and enhance relationships within the provider community, including behavioral health homes, community mental health centers, hospitals and individual providers (BH Providers and PCP's) and groups identified that are participating in Physical/ Behavioral integration activities.

Designs, develops and implements behavioral health related clinical training for associates and providers.

Works with utilization, case and disease management teams to implement and operationalize BH/PH integration iniatives.

Educates health plan leadership and cross functional staff on behavioral health and integration strategy ensuring all entities understand and support the initiatives.

Produces professional presentations and training materials to be utilized for training of providers and associates.

Manages behavioral health specific policy and procedure development, clinical program descriptions, and other related documentation requirements.

Assists with behavioral health provider and/or home provider audits as needed.

Assists with analysis of behavioral health utilization data, KPI review and monitoring of behavioral health utilization management metrics. Participates with development of corrective action plans and associated activities for areas that need improvement.

Performs duties and responsibilities as assigned Additional Responsibilities:

Assist behavioral health home candidates to prepare their organization for becoming Patient-Centered Specialty Practice (PCSP) recognized through NCQA.

Oversees compliance with behavioral health home contracts and standards.

*LI-WellCare','!*!Candidate Education:

Required a Master's Degree in counseling, social work, psychology, nursing, or related human service field Candidate Experience:

Required 5 years of experience in behavioral health, preferably in public sector

Preferred managed care experience Candidate Skills:

Intermediate ability to lead/manage others in a matrixed environment

Intermediate demonstrated project management skills

Intermediate ability to work independently Ability to work independently or part of a team

Intermediate ability to work as part of a team

Intermediate strong people skills

Intermediate ability to apply Lean/Six Sigma industry standard application and methodologies preferred

Intermediate comfortable presenting in front of large groups

Intermediate ability to redefine business approaches and processes to meet objectives

Intermediate ability to think outside the box, structure an ambiguous opportunity, determine ROI and build business case for projects

Intermediate possess strategic enterprise wide view while maintaining attention to detail Licenses and Certifications:A license in one of the following is required:

Required Licensed Clinical Mental Health Counselor (LCMHC)

Required Advanced Practice Registered Nurse (APRN)

Required Licensed Clinical Marriage & Family Therapist (LCMFT)

Required Licensed Clinical Social Worker (LCSW)

Required Licensed Registered Nurse (RN) Technical Skills:

Required advanced Microsoft Word, PowerPoint, Excel, Project and Outlook

Required advanced Microsoft Excel

Ability to learn company approved software

Required Intermediate Healthcare Management Systems (Generic)

','US-IL-Chicago','29 North Wacker Dr','Suite 300','Chicago','60606','','No','No','No','Behavioral Health Program Manager

96 days 11 hours ago

Wellcare

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Behavioral Health Program Manager Wellcare - Chicago, IL, United States

   

Location: Chicago, IL

Company Profile:
WellCare Health Plans, Inc. focuses exclusively on providing government-sponsored managed care services, primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, to families, children, seniors and individuals with complex medical needs. The company served approximately 3.8 million members nationwide as of Sept. 30, 2015. For more information about WellCare, please review our website and view the company’s videos. WellCare has developed a full complement of expertise in three major areas of government-sponsored health care…. Medicaid, Medicare Advantage and Medicare Prescription Drug Plans. Leveraging our expertise for our members' benefit is a key part of the value we bring to our members. WellCare focuses on those members who are dually eligible for both Medicaid and Medicare. This is an area of specialization that many other health plans simply do not have. We are committed to continually improving the quality of care and service that we provide to our members. We help our members access the right care at the right time in the appropriate setting. For some members, this includes the use of coordinated care teams and community partnerships. And we’re focused on government customers and use a disciplined approach to ensure a competitive cost structure.