Project Manager of Behavioral Health Operations

Amida Care, the largest Medicaid HIV Special Needs Plan in NY, delivers a uniquely effective care model that has become a true benchmark for innovation, engagement, and member health outcomes.

Our mission is to provide access to comprehensive care and coordinated services that facilitate positive health outcomes and general well-being for our members.

This true integrative care model addresses psychosocial, housing, behavioral and medical services directly evolving around the needs of each member.

We are a community of individuals from diverse peoples who work together to actively foster a fair, equitable, inclusive environment where all employees receive an invitation to belong.

Visit Amidacareny.org for more information about the Amida Care culture.

We are actively seeking a highly motivated, innovative, and experienced leader to join our team as the Manager of Behavioral Health Operations.

Compensation will be commensurate with experience.

Position Summary :

This position supports the Integrated Care and Behavioral Health area of health services through oversight and organization of administrative efforts, including but not limited to, vendor relations, tracking, coordinating and management of implementation of new benefits;

tracking of departmental and cross functional initiatives; liaises with appropriate support departments within Amida Care to facilitate projects and outcomes.

Serves as a key point of contact for assigned regulatory related matters.

Responsibilities :

• Serves as behavioral health lead for the management of coordination and implementation of Care Management System.
• Department point person for our Behavioral Health Vendor along with IC / BH leadership for tracking, coordination, and implementation purposes.

Collaborates with Amida Care's Director of Vendor Performance to ensure oversight activities are completed, documented, and disseminated for appropriate follow up.

• Partner with leadership to develop and document departmental workflows and related training materials. Provides staff training as needed.
• Serves as departmental lead to collaborate on compliance / regulatory and quality matters. Develops presentations and responses to queries, deficiencies and other items that impact regulatory compliance.

Performs appropriate follow up and tracking to ensure that deficiencies are rectified, and necessary changes are implemented.

• Provide support and / or coordination for various audits and / or plans of correction (such as Article 44 / 49 or IPRO coordination of care) in conjunction with appropriate vendors, internal departments, providers, and other entities as needed.
• Attend and represent Amida Care at various State meetings related to Behavioral Health and departmental initiatives. Documents meeting notes, disseminates information to appropriate parties and coordinates implementation of changes / updates in conjunction with other departmental and organizational leadership.
• Lead process of behavioral health benefits management, by coordinating with appropriate staff and related / impacted vendors around benefit administration.
• Update and review Amida Care Benefit Guide / Grid related to Behavioral Health or other benefits under the area's purview, in a timely manner.

Ensure new benefits are implemented following all regulatory and Amida Care protocols. Responsible for reviewing and ensuring that Amida Care's website reflects all necessary benefits and informational requirements according to the model contract and benefit RFQ's.

Develop and update the department's letters and create and maintain a central repository for the letter library. Coordinate with Amida Care's compliance department to get necessary correspondence submitted and approved by BPIE.

Track all documents from submission to approval.

Amida Care is Diversity, Equity and Inclusion employer committed to full inclusion and elimination of discrimination in all its forms.

We strive to develop, promote and sustain a culture that values equity and leverages diversity and inclusiveness in all that we do.

EDUCATION REQUIRED

Bachelor's degree in business, health care, project management or a similar field or an equivalent combination of education and related experience.

EXPERIENCES AND / OR SKILLS REQUIRED

Three years' (3) experience in a health-related project management capacity and one year's experience supervising professional staff in an office environment.

3) years of Medicaid managed care experience required with behavioral health and children's services. Knowledge of parity preferred.

• Experience developing and / or updating training materials, workflows and policies as well as conducting training on such materials.
• Strong computer competency (MS Office applications) as well as experience with project management software is required as is excellent attention to detail.
• Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts.
• Demonstrate appropriate behaviors in accordance with the organization's vision, mission, and values.
1 day ago