VP, Clinical Care Services, Public Sector/Medicaid Focused

United States

Job Description

Responsible for the leadership and performance of all clinical positions in the Public Sector/Medicaid Programs which the incumbent will lead. Focused on the delivery of high quality, cost effective care, service, supporting new business development, and the clinical model design. This position serves in a results-oriented operations role and is accountable for clinical results, including all utilization and care management programs and outcomes. This role is accountable for the consistent implementation and effective management of clinical policies, procedures and best practices.

- Develops and communicates clinical team objectives.
- Establishes performance goals for clinical staff and ensure continuous feedback regularly,

throughout the year.  Manage attrition effectively.
- Implements and manages cost-effective and high quality utilization, care, disease

management and other clinical programs, including service center performance reviews,

corrective actions and plans. 

- Sets performance standards and put processes in place to regularly and consistently

measure qualitative performance.
- Puts processes in place to identify developmental needs of team members and a means of

addressing those needs.
- Manages cost of care and utilization to achieve the most effective financial performance

while ensuring appropriate quality of care. Manage financial performance on a unit cost an

operating basis.
- Develops and manages clinical operating budget.  Participate in strategic planning and

clinical model and policy development as requested by leadership.
- Avoids payment of performance penalty and optimize opportunities to earn incentives.
- Participates in underwriting process.

- Effectively supports new business development.

MINIMUM REQUIREMENTS:

- License: RN, LCSW, or LPC.

- 7-10 years experience in professional practice, plus a minimum of 5 years in a senior

  management/leadership position in managed care. Experience must include a minimum of 5

  years post-degree (masters/doctoral) experience in behavioral health.

- Track record of strong clinical utilization and care program management (may include EAP

  and CISM programs), general management, supervisory, team building and leadership skills.

OTHER:

Excellent writing and communication abilities; direct clinical experience in multiple settings and levels of care, including both mental health and substance abuse; knowledge of relevant federal and state regulations pertaining to managed behavioral health and insurance products.

Working knowledge of Microsoft Office suite.

General Job Information

Title

VP, Clinical Care Services, Public Sector/Medicaid Focused

Grade

31

Job Family

Clinical Services Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

8/22/2019

Date Requisition Created

8/22/2019

Work Experience

Behavioral Health, Clinical, Management/Leadership

Education

Masters: Behavioral Health (Required)

License and Certifications - Required

BCBA - Board Certified Behavior Analyst - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt

License and Certifications - Preferred

Other Job Requirements

Responsibilities

Track record of strong clinical utilization and care program management ( public sector / Medicaid focused ), general management, supervisory, team building and leadership skills.

Excellent writing and communication abilities; direct clinical experience in multiple settings and levels of care, including both mental health and substance abuse; knowledge of relevant federal and state regulations pertaining to managed behavioral health and insurance products.

Working knowledge of Microsoft Office suite.

6 -10 years experience in professional practice, plus a minimum of 5 years in a senior management position in managed care.

Experience must include a minimum of 5 years post-degree (masters/doctoral) experience in behavioral health.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.

“I receive a high level of support from our Senior Management Team to execute on our vision. They are always accessible and approachable, something I’ve found to be very unique to Magellan.”