Manager, Behavioral Health; Outpatient UM & Programs

Who We Are

Point
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Health is a leading not-for-profit health and well‑being organization dedicated to delivering high‑quality, affordable healthcare. Serving nearly 2,000,000 members, Point
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Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviours and decisions. We’ve had a long‑standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are.

We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

Under the oversight of the Director, Behavioral Health, the Manager, Behavioral Health is responsible for leading at least one Behavioral Health functional team, managing team performance and results, and for managing the clinical processes that support the Behavioral Health department. The Manager, Behavioral Health is a member of the Behavioral Health leadership team; in addition to their own responsibilities the Manager assists in supporting and covering for other Behavioral Health leaders and participates in a variety of cross‑functional Behavioral Health initiatives and processes.

The Manager, in collaboration with the Director, is responsible for the development, implementation and maintenance of Behavioral Health initiatives and projects, as well as achievement of goals consistent with federal, state, and national requirements and regulations, and specific Tufts Health Plan initiatives and goals. The position is responsible for representing the Behavioral Health department on relevant internal and external work groups, implementation teams, and projects, for interfacing with divisional and enterprise teams, and for managing Behavioral Health accreditation compliance.

• Manage daily operations including, but not limited to, the assignment and distribution of work among assigned Behavioral Health Utilization Management team(s). Ensure all workflow processes are completed within the required time frames and telephone coverage requirements are met. Ensure adherence to all department and regulatory standards.
• Serve as member of Behavioral Health leadership team. Provide back‑up for peers, including supervisory coverage. Partner with peers to ensure effective cross‑functional, end‑to‑end approach to meet the needs of members, providers, and internal and external stakeholders.
• Support and help drive efforts to integrate Behavioral Health into the broader Tufts Health landscape by providing a cohesive behavioral health presence and subject matter expertise to Public Plans and Enterprise activities including case management, medical management, and provider/network management.
• Under the direction of the Director of Behavioral Health, develop, implement and manage initiatives and projects to achieve Tufts Health Public Plans goals. Collaborate with internal departments in support of clinical activities and operations.
• Manager of Children’s Behavioral Health Initiative (CBHI) team completes extensive network management activities in coordination with Mass Health and other MCOs/ACOs.
• Develop and prepare reports to meet internal, regulatory, contractual and accreditation requirements. Work closely with other departments in the development of report specifications and obtain data for and/or complete reports as needed to meet contract and regulatory requirements and track ongoing data.
• Hire, train, and manage staff. Supervise/coach staff to assist them in attaining optimal knowledge and job efficiency. Define metrics and goals for assigned team(s) and manage expectations. Utilize data to monitor and evaluate individual, team and program performance. Provide timely feedback to all staff regarding their performance via regular team and one‑on‑one meetings. Conduct formal performance appraisals. Take appropriate disciplinary action in a timely manner when…