Department: Health Services
Reports to: VP Medicaid Product and Regulatory Affairs
Location: 3031 North Rocky Point Drive, Tampa, FL 33607
Develops and drives the policies, operational planning, and execution of performance for the State's Severely Mentally Ill (SMI) program. Evaluates market performance and industry trends, and provides both strategic and tactical direction across all clinical and operational activities. Develops and maintains relationships across the State with key stakeholders that are critical to the performance of the SMI program, including State agencies, behavioral health providers, community organizations, and advocacy groups.
Additional Responsibilities: Candidate Education:
- Drives, manages and executes the strategy and program performance for the SMI program.
- Liaises across multiple key internal functional areas (Clinical, Network, Finance, etc.) to drive decisions and initiatives critical to the success of the plan.
- Engages with external constituents such as AHCA, community and advocacy groups, key providers, and other stakeholders to build strong working relationships and deliver results.
- Effectively partners to organize resources and integrate processes to optimize program performance, program effectiveness, profitability, and outcomes.
- Partners with the Network team and Behavioral Health (BH) providers to design and implement strategies to improve and evolve the delivery system for the SMI program in the assigned market, including working collaboratively with providers to encourage development of value-based payment models that reward and encourage integrated medical / behavioral care.
- Performs strategic planning and annual forecasting activities for the SMI program, including the development of financial targets and measurements.
- As a result of collaborative partnerships, shares responsibility for program Quality Improvement & accreditation initiatives in the assigned market.
- Ensures compliance requirements and State reporting related to the plan are achieved in accordance with service level agreements.
- Performs other duties as assigned
- Required A Bachelor's Degree in a related field
- Preferred A Master's Degree in a related field
- Required 10 years of experience in Healthcare or health insurance industry
- Required 5 years of experience in Product management / development roles
- Required 7 years of experience in Behavioral Health leadership roles
- Required 7 years of experience in Managing or leading teams
Licenses and Certifications:
- Advanced Ability to effectively present information and respond to questions from families, members, and providers
- Advanced Demonstrated interpersonal/verbal communication skills
- Advanced Ability to effectively present information and respond to questions from peers and management
- Advanced Demonstrated leadership skills
- Advanced Demonstrated written communication skills
- Advanced Ability to work in a fast paced environment with changing priorities
- Advanced Demonstrated organizational skills
- Advanced Other Have a clear understanding of the managed care field and managed care operating components, with emphasis on clinical management of behavioral health services, particularly within an integrated managed care model.
- Advanced Knowledge of community, state and federal laws and resources
A license in one of the following is required:
- Required Intermediate Microsoft Outlook
- Required Intermediate Microsoft Word
- Required Intermediate Microsoft PowerPoint
- Required Intermediate Microsoft Excel
- Required Intermediate Healthcare Management Systems (Generic)