Clinical Director for Behavioral Health Services
About The Position
The Clinical Director for Behavioral Health Services provides senior leadership for the Health Plan's behavioral health strategy, ensuring clinically sound, compliant, and measurable programs across delegated and internal partners. This role exists to strengthen integration between behavioral health and medical care management while advancing quality, utilization, and member experience outcomes. Key responsibilities include directing and evaluating behavioral health and social service programs for Medicare Total Advantage and Medicare Health Advantage; serving as primary liaison to the delegated behavioral health vendor; overseeing regulatory readiness and clinical program compliance; and guiding policy and procedure development to meet managed care requirements.
Requirements
- LMSW or LCSW license
- Bachelor's degree
- 1-3 years of behavioral health managed care case management experience
- 3-5 years of Serious Mental Illness and Substance Use Disorder experience (psychiatric inpatient/outpatient preferred)
- Strong process/workflow design and project management in a matrixed, cross-functional environment
Nice To Haves
- psychiatric inpatient/outpatient experience
Responsibilities
- Directing and evaluating behavioral health and social service programs for Medicare Total Advantage and Medicare Health Advantage
- Serving as primary liaison to the delegated behavioral health vendor
- Overseeing regulatory readiness and clinical program compliance
- Guiding policy and procedure development to meet managed care requirements
- Reviewing plan priorities and time-sensitive items from internal teams and the delegated vendor
- Aligning on performance trends, documentation expectations, and upcoming regulatory needs
- Translating complex requirements into clear program guidance
- Refining clinical workflows
- Preparing concise updates for leadership
- Balancing focused analysis time with cross-functional collaboration
- Keeping decisions grounded in member outcomes and operational practicality
- Staying accessible for critical escalations and partner questions as they arise
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What This Job Offers
Job Type
Full-time
Career Level
Senior
