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Director, Behavioral Health, Health Plans
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- Participates in the development and implementation of the behavioral health sections of the Quality Management (QM)/Utilization Management (UM) Plan. Oversees the administration of all BH QM/UM and performance improvement activities, encompassing grievances and appeals, and contributes to various other subcommittees such as Compliance and Pharmacy.
- Develops, implements, monitors and evaluates Utilization and Care Management metrics specific to Behavioral health services across all plan types as necessary.
- Plans leadership and medical director meetings as stipulated by the State BH contract manager.
- Acts as liaison for new projects and leads process improvement initiatives aimed at achieving operational goals and return on investment (ROI).
- Engages in advocacy groups to champion the quality of behavioral health and social care in the MCO population.
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