Medi-Cal Behavioral Health Program Manager, Consultant

Blue Shield of California • Woodland Hills, CA

9d

About The Position

Your Role The Medi-Cal Behavioral Health Services team drives operational excellence and regulatory compliance for the office of the Chief Medical Officer for Blue Shield Promise Health Plan. The Medi-Cal Behavioral Health Program Manager, Consultant will report to the Director of Clinical Access Programs & Medi-Cal Behavioral Health Services. In this role, you will lead cross-functional initiatives to improve behavioral health outcomes, collaborate with stakeholders to ensure regulatory and audit readiness, manage committee administrative activities, and drive continuous improvement in program operations. This role demands strong project management skills, coordination of cross-functional teams, coordination of large interdepartmental meetings, and expertise in Medi-Cal regulatory requirements. Responsibilities Your Work In this role, you will:

Requirements

• Requires a bachelor’s degree or equivalent experience
• Requires at least 7 years of prior relevant experience
• Requires proficient knowledge of Medi-Cal regulations and guidelines, reporting requirements, and submission procedures
• Requires administrative or clinical behavioral health experience in a health plan or medical group setting
• Requires excellent communication skills, both oral and written and requires effective time management skills and ability to define and act on priorities efficiently
• Requires investigative, problem solving, critical thinking and assessment skills
• Requires strong organizational skills, project management experience strongly preferred
• Committee governance and regulatory compliance strongly preferred
• Demonstrated experience in cross-functional operational improvement activities strongly preferred
• Ability to understand and interpret regulations including Senate Bills, Assembly Bills and DHCS/DMHC All Plan Letters strongly preferred
• Requires advanced skills with computer programs, including Microsoft Excel, Outlook, Word, and PowerPoint, SharePoint and other collaboration platforms

Responsibilities

• Provide overall program leadership, guidance, and manage all aspects of the Promise Behavioral Health Committee, including the standardization of committee charters and meeting regulatory, reporting, and contractual requirements
• Provide strategic direction, planning and execution of Medi-Cal behavioral health programs, for regulatory compliance and/or quality improvement, from conceptualization through implementation
• Develop and optimize resource strategies to support projects and daily operations
• Lead cross-functional meetings and foster teamwork; drive escalation and resolution of issues, while promoting collaboration and coordination across broad categories of stakeholders
• Develop reports for leadership to understand ongoing compliance, gaps, and risks, as requested
• Provide technical expertise in planning, execution, and leadership of programs, projects, and initiatives
• Ensure regulatory audit preparation and performance for Medi-Cal behavioral health
• Assess and resolve all high priority program risks as they are encountered
• Manage the development and implementation of behavioral health projects involving departmental or cross-functional teams focused on delivery of new or existing internal/external programs and/or products
• Serve as a subject matter expert to regularly brief key stakeholders on different aspects of assigned initiatives
• Organizes the interdepartmental activities ensuring completion of projects within the program are on schedule and maintains files of all current and historical artifacts for the behavioral health department

What This Job Offers

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