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Job Title:
Director, Behavioral Health, ASD and Member Services Agency:
Department of Community Health
Job Requisition ID:
JR0000007915 Shift:
Not Applicable (United States of America) Compensation Details:
$95,000 - $115,000
Job Description:
ESSENTIAL DUTIES AND RESPONSIBILITIES
Strategic leadership and policy. In coordination with the Executive Director of MAP, sets the vision, priorities and annual work plan for the Behavioral Health unit. Directs behavioral health policy, provider manuals, State Plan Amendments and waivers. Leads new initiatives such as Targeted Case Management, certified community behavioral health clinics (CCBHCs), crisis services, reentry and integrated care. Advises executive leadership on federal and state developments.
Parity compliance. Serves as the Department’s lead for mental health and substance use disorder parity under the federal Mental Health Parity and Addiction Equity Act and Georgia HB 1013. Directs annual reviews of the care management organizations (CMOs) and fee-for-service Medicaid and drives corrective action.
Program, benefit and ASD oversight. Oversee behavioral health and ASD benefit policy, prior authorization standards and provider requirements. Oversees relationships with residential and inpatient treatment settings, as well as out-of-state single case agreements and provider enrollment. Partners with program integrity on oversight of high-risk providers.
Managed care oversight. Serves as the primary behavioral health liaison to the Georgia Families CMOs. Provides SME reviews and feedback on CMO deliverables as required, recommends contract language and monitors performance. Recommends corrective action in partnership with CMO and Compliance leadership.
Grants, waivers and special projects. Assists, and, when necessary, leads the Department’s Medicaid health home initiatives involving behavioral health or foster youth. Serve as project director or business owner for federal and philanthropic grants, ensuring compliance, timely reporting and long-term sustainability.
Interagency and stakeholder leadership. Represents DCH with DBHDD, DFCS and other state partners, on statewide committees, and with providers, and advocates. Delivers briefings and presentations on behalf of the Department on as needed basis.
Member services. Oversee behavioral health member services and the resolution of complex, cross-agency member cases, with a focus on children and youth with intensive Oversees behavioral health member services and the resolution of complex, cross-agency member cases, with a focus on children and youth with intensive needs. When needed, provides direct one-on-one case management and family support for fee-for-service members in complex cases. Uses complaint trends to drive improvement.
Data, quality and accountability. Establishes key performance indicators and uses data to guide policy and program decisions. Ensures timely, accurate responses to CMS, auditors, the General Assembly and other oversight bodies.
Team leadership. Hires, develops, evaluates and mentors staff. Fosters a collaborative, accountable culture and supports succession planning and professional development for critical roles.
PREFERRED QUALIFICATIONS
Master’s or doctoral degree in a behavioral health discipline, public health or public administration. A current, unrestricted Georgia behavioral health license (e.g., LCSW, LPC, LMFT, psychologist, PMHNP) is preferred.
Five or more years of Medicaid behavioral health policy or program experience, including managed care, and three or more years leading professional…