Director, Behavioral Health Performance Monitoring & Improvement

Your Role

The Behavioral Health Services (BHS) team is responsible for developing the foundation for and executing a best-in-class behavioral health product for Blue Shield, including creating pricing models by line of business, and establishing a core operations infrastructure. The Behavioral Health Operations Oversight team ensures behavioral health program integrity and compliance with state and federal regulatory standards and accreditation standards. The Director of Behavioral Health, Program & Project Management with a specialization in Performance Monitoring & Improvement, will report to the Sr. Director of Behavioral Health Operations Oversight.

In this role you will work closely with management and employees to assess, diagnose and improve behavioral health operations performance and facilitate compliance with applicable federal and state regulatory requirements. The Director of Behavioral Health, Program & Project Management will work with business owners to ensure an understanding of new and existing regulatory requirements to escalate and resolve risks identified through the assessment process, promote ongoing program integrity and compliance, and collect and review necessary documentation in support of preparing for successful surveys/audits. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Requires a Bachelor's degree (industrial engineer preferred) or equivalent experience

• Requires a minimum of 10 years prior relevant experience.

• Preferred experience in a managed care healthcare setting with an emphasis on continuous quality/process

• Requires at least 6 years of management experience

• Requires the ability to lead through influence and operating comfortably in a highly matrixed environment

• Prefers at least 5 years' experience working with internal and external stakeholders to improve performance

• Requires experience implementing and overseeing a quality program, initiative or committee

• Requires experience using healthcare data to drive improvements

• Strong analytical skills, including the ability to determine the impact of regulation on processes

• Ability to prioritize and manage work and trade-offs against critical project timelines in a fast-paced environment

• Strategic thinker with end-to-end view who has an eye for detail, is organized, and can manage multiple programs simultaneously

• Excellent influence and engagement skills in building alignment and accountability without formal ownership or authority over talent resources

• Ability to build strong and sustainable relationships and the capability to interact within all levels of the organization

• Ability to work cooperatively and strategically in a team environment with all levels of professional, technical and administrative staff and to integrate resources on a timely and organized basis

• Acumen to handle complex situations and multiple responsibilities simultaneously with the urgency of immediate demands on the operations

• Strong communicator, PowerPoint/Storyboarding skills. Ability to present information clearly and concisely to various audiences