Manager, Behavioral Health

Blue Cross and Blue Shield of Louisiana

17h

About The Position

This position is responsible for personnel administration including selection, coaching, motivation, discipline, continuous improvement and compliance This position is responsible for managing complex behavioral health inpatient and outpatient cases, prospective and retrospective review cases, claims review, accurate administration of benefits, and appeals and grievances. How You Contribute to the Company’s Mission in this Role: Manages strategic planning designed to achieve departmental, divisional and/or company goals. Serves on corporate committees/project teams to design and implement customer and/or provider service programs that support corporate initiatives and Behavioral Health Operational Objectives. Manages multiple staff level positions by administering all HR functions, including but not limited to, hiring, terminating, conducting performance reviews, managing work schedules, managing a budget, assigning and directing workload, training and developing staff, coaching, etc. to help ensure departmental, divisional and/or corporate goals are set and obtained. Plans, documents, and analyzes workflows, policies and activities to ensure proper documentation, tracking, auditing, and analysis of work efforts. Maintains documentation of program and quality improvement activities in required formats for accreditation/regulatory bodies. Develops and manages peer relationships in other divisions across the company to help ensure that all areas of member touch points are engaged and work to improve member and/or provider satisfaction. Resolves non-routine issues with appropriate internal and/or external audiences to ensure appropriate resources are allocated and available to provide customer service that aligns with departmental, divisional and/or corporate goals. Analyzes system usage to identify problems, design, test, and initiate changes, as well as improve, develop and implement processes with appropriate departments to ensure optimal system design and usage. Reviews and develops policies and procedures with appropriate internal and/or external audiences to manage service level agreements, quality assurance and timeliness to ensure compliance, consistency, effectiveness and efficiency across all assigned units.

Requirements

• Bachelor’s in behavioral health related field, nursing, business management, healthcare administration or a related field
• 5 years of experience in a behavioral health environment analyzing policies and procedures, improving operational processes and providing proactive service solutions with 2 years of leadership experience
• Strong analytical, organizational, management, communication and interpersonal skills required.
• Ability to make decisions, prioritize, find solutions, and work independently.
• Working knowledge of relevant PC software, and proficient in Microsoft Office suite.
• Strong knowledge of the Behavioral Health service delivery continuum.

Nice To Haves

• Experience managing staff with direct reports.
• Leadership experience in a behavioral health organization.
• Experience using phone technology or forecasting to establish staffing needs.
• Working knowledge of claims billing code sets is strongly preferred.
• Experience and knowledge of Epic systems and program development.

Responsibilities

• Manages strategic planning designed to achieve departmental, divisional and/or company goals.
• Serves on corporate committees/project teams to design and implement customer and/or provider service programs that support corporate initiatives and Behavioral Health Operational Objectives.
• Manages multiple staff level positions by administering all HR functions, including but not limited to, hiring, terminating, conducting performance reviews, managing work schedules, managing a budget, assigning and directing workload, training and developing staff, coaching, etc. to help ensure departmental, divisional and/or corporate goals are set and obtained.
• Plans, documents, and analyzes workflows, policies and activities to ensure proper documentation, tracking, auditing, and analysis of work efforts.
• Maintains documentation of program and quality improvement activities in required formats for accreditation/regulatory bodies.
• Develops and manages peer relationships in other divisions across the company to help ensure that all areas of member touch points are engaged and work to improve member and/or provider satisfaction.
• Resolves non-routine issues with appropriate internal and/or external audiences to ensure appropriate resources are allocated and available to provide customer service that aligns with departmental, divisional and/or corporate goals.
• Analyzes system usage to identify problems, design, test, and initiate changes, as well as improve, develop and implement processes with appropriate departments to ensure optimal system design and usage.
• Reviews and develops policies and procedures with appropriate internal and/or external audiences to manage service level agreements, quality assurance and timeliness to ensure compliance, consistency, effectiveness and efficiency across all assigned units.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager