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WorkSource Oregon Behavioral Health Manager in KLAMATH FALLS, Oregon

Required: * Bachelor\'s degree from four-year college or university in related field; behavior provider or THW with at least 5 years of clinical experience; or equivalent combination of education and experience * Active license as a LMFT, LCSW, LPC, THW, psychiatric nurse practitioner, RN, or clinical psychologist * Computer skills Summary: This position is responsible for oversight of Behavioral Health (BH) services which includes Mental Health (MH) and substance use disorder (SUD) treatment provided to members to assure the needs of the members are met. This includes a special focus on members with severe and persistent mental illness. This position will also be accountable for oversite of the BH System of Care (SOC) for the service area and advance the integration of BH with physical health and dental health. Essential Duties and Responsibilities: 1. Oversees and coordinates BH care across a continuum of care settings to assure appropriate care and achievement of optimal outcomes 2. Drives innovation of the BH service delivery in the community 3. Manages BH case management and BH utilization management including prior authorizations 4. Leads the management of contact deliverables and compliance related to BH services Duties Include: * Ensures a coordinated approach to BH care planning while ensuring appropriate use of health care resources * Participates in BH utilization review and case management activities * Provides BH expertise and consultation services internally to improve member engagement and the effectiveness of the case management, quality management and pharmacy departments * Develops strategies to improve the health outcomes of members with severe and persistent mental illness and members with co-occurring BH and complex chronic conditions * Contributes to the development of BH integration and parity, and drives implementation of strategies to achieve integration in collaboration with community partners * Attends, participates, and/or coordinates regular meetings with community partners to facilitate care coordination, access to care, and program development and monitoring * Oversees the determination of appropriate level of care, quality of care, and explores alternative levels of care for members with BH needs * Works with the Medical Management team in reviewing complex cases and authorization requests * Facilitates orderly and timely transition from one care setting to another * Prevents avoidable hospitalization, thus avoiding costs and risks encountered in institutional settings * Collaborates with other departments and community partners to improve communication and care processes * Participates in process improvement projects and maintains department operating instructions and procedure manuals related to BH programs and services * Maintains confidentiality and complies with HIPAA rules and regulations * Maintains punctual, regular and predictable attendance * Work collaboratively in a team environment

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