Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY:

The Behavioral Health Program Manager is accountable for the operational management of the Behavioral Health Team. Assists the Director of Behavioral Health with human resources, quality, and financial management of the program. The Program Manager oversees implementation of case management and utilization functions for Behavioral Health. Serves as a clinical leader and resource for Behavioral Health.  Assists the director with the implementation of policy and procedures, and adherence to regulatory and non-regulatory standards.  Provides assistance with evaluations and reports relevant to achievement of goals for the Utilization Management and Case Management teams. Provides oversight to ensure area staff utilization and engagement patterns are congruent to standards.

MINIMUM QUALIFICATIONS:

  • Education/Specialized Training/Licensure: Master's Degree in Social Work or Counseling required.
  • Current unrestricted license in the state of Texas: LCSW, LMSW, LMFT or LPC
  • Work Experience (Years and Area): 3 to 5 years' experience in case management and utilization management combined.
  • Management Experience (Years and Area): 1 year experience managing cross functional teams in managed care environment
  • Equipment Operated: Advanced PC Skills, MS Word, MS Excel, MS Outlook,


SPECIAL REQUIREMENTS: 

  • Communication Skills:
  • Above Average Verbal (Heavy Public Contact)
  • Exceptional Verbal (e.g., Public Speaking)
  • Writing /Composing: Yes   (Correspondence/ Reports )

Other Skills:

  • Medical Terminology
  • Typing
  • wpm
  • PC
  • MS Word
  • MS Excel
  • Advanced Education: Advanced Training Specialty: LCSW, LMSW, LMFT or LPC, Master's Degree Major: Master's Degree required in Social Work, Counseling or related field
  • Work Schedule: Flexible

Other Requirements:

  • Excellent organization, coordination, and multi-tasking skills and abilities. Ability to organize and prioritize tasks and work independently. Strong attention to detail and deadlines


RESPONSIBLE TO:
Director

EMPLOYEE SUPERVISED:
None

Application Instructions

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