VP, Psychiatry and Behavioral Health

Summary of Position

• Oversee plan's behavioral health medical functions. Lead clinical oversight of behavioral health services/programs.
  
• Engage with stakeholders to emphasize the importance of clinically driven, holistic mental health treatment.
  
• Evaluate provider network quality and work to deepen partnerships with high performing groups; and evaluate health plan member-facing technology applications to improve engagement.
  
• Lead Plan efforts to integrate physical medicine and behavioral health services including coordinating those efforts with medical leadership at ACPNY.
  
• Execute on BH long term strategy including any insourcing or outsourcing, evaluation of network providers and vendors in partnership with vendor management and operational leads.
  
• Execute on key departmental initiatives such as network expansion, direct contracting, BH concierge and development of BH service line. Attend Plan Medical Director meetings and participate in quality programs.
  
• Research and develop/implement appropriate KPIs to measure and report return on investment for BH efforts.
  
• Identify and execute opportunities to create efficiency, remove obstacles, or create improved systems, processes, and approaches within the Mental Health Administration function.
  
• Mentor, develop and guide teams, minimizing performance gaps while ensuring an effective succession pipeline.
  
• Set KPIs, and use data to drive decisions, ensuring effectiveness and hitting targets.

Principal Accountabilities

• Drive the strategic planning process, inclusive of quarterly and annual planning integrated with company annual process, ensuring goals are aligned with overall corporate goals.
  
• Provide thought leadership to articulate and help build an effective and efficient medical delivery program.
  
• Develop annual goals and oversight of BH department/function. Establish and maintain continuity in the planning, development and implementation of policies, operational processes, workflows required to execute organizational strategies and to ensure consistency in process application throughout Care Management.
  
• Provide clinical leadership both internally and externally. Serve as an essential liaison among Senior Management, Plan staff, vendors, and membership to promote and improve communication and operations areas of medicine including Childhood, Adolescent and Adult Psychiatry. Chair/co-chair committees on quality and Utilization Management and parity and represent BH on medical management and pharmacy (P&T committees). Represent BH on medical management and pharmacy (P&T committees).
  
• Oversee the daily clinical operation and administration of a Behavioral Health (BH) function to support improved utilization results across the spectrum of medical specialties. Direct service delivery to high-risk populations, community settings and care of medical patients. Carry out assigned programs to ensure the delivery of quality medical care to EmblemHealth membership, ensuring compliance with contractual obligations and standards, and assist in the development and implementation of new policy and programs as needed.
  
• Ensure operational effectiveness and oversight of assigned functions, assuring regulatory compliance and accreditation with Department of Health, Department of Insurance, CMS, NCQA, and URAC standards. Manage implemented network initiatives such as the BH concierge line.
  
• Build out and integrate data reporting and dashboards to better manage member's behavioral health. Make sound decisions based on all available data. Validate and monitor adherence to implemented policies, procedures, workflows and processes: identify, recommend and implement improvement initiatives accordingly.
  
• Generate methods to develop and improve the overall delivery and performance of the department. Implement process improvements in a timely manner. Increase productivity and revenue growth.
  
• Enhance cross-functional collaboration. Support other areas in implementing cross-departmental changes. Deal effectively with and lead others throughout Company and delegated vendor(s) structure.
  
• Be a model of corporate culture and values and demonstrate commitment to employee engagement and growth.