Behavioral Health Program Manager

Why consider this job opportunity

• Salary up to $ annually
• Comprehensive benefits package, including recognition programs and support for professional growth
• Opportunity for career advancement within a leading healthcare organization
• Flexible remote work options with occasional office visits
• Collaborative work environment that values team contributions and innovative thinking
• Chance to make a significant impact on behavioral health programs and patient care

• Develop and implement policies and procedures for BH clinical programs in compliance with CMS and EOHHS regulations
• Oversee auditing of BH Medicare reporting and assist in corrective action plans for identified deficiencies
• Serve as the point of contact for BH member and provider issues, including escalations
• Collaborate with the Compliance department to create and execute Corrective Action Plans for non‑compliance issues
• Conduct data analysis and program evaluations to support clinical initiatives and recommendations

• Master's degree required
• Minimum of 5-7 years of Medicare and/or Medicaid health insurance experience
• At least 3-5 years of compliance experience within a regulatory framework
• Minimum of 2-3 years of managed care or managed behavioral healthcare experience, including data analysis and reporting
• Strong communication skills, both written and oral

• Licensure as LICSW, LMHC, or LMFT
• 2-3 years of CMS/Medicare auditing experience
• 2-3 years of mental health parity experience
• Proven leadership skills and a strong track record in executing projects on time and within budget
• Ability to translate complex topics for various audiences effectively

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