Humana

Behavioral Health Strategy Lead

South Carolina, United States

Not SpecifiedCompensation
Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Behavioral Health Strategy Lead

Employment Type: Full-time

Position Overview

Become a part of our caring community and help us put health first. The Behavioral Health Strategy Lead builds behavioral health strategies within the enterprise, business, or segment to develop best practices and processes to improve outcomes for members. The Behavioral Health Strategy Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

This position requires residence in South Carolina.

The Behavioral Health Strategy Lead is a strategic contributor responsible for the development and refinement of behavioral health programs tailored to the needs of Medicaid plan members in South Carolina. This role involves a deep understanding of quality measures and principles of behavioral health, as well as engaging with providers and stakeholders to advocate for key policies that enhance the delivery of integrated care. The lead will collaborate closely with the Health Services Director, Chief Medical Officer, and various stakeholders to develop innovative products and services within Humana's Medicaid BH delivery model.

Key Responsibilities

  • Develop, implement, and refine behavioral health programs that meet the diverse needs of populations served, ensuring alignment with evidence-based practices and compliance with local and federal regulations.
  • Analyze data and trends in behavioral health services to identify opportunities for program innovation and improvement.
  • Understand and apply quality measures specific to behavioral health, utilizing them to inform program development and enhance outcomes for plan members.
  • Collaborate with the Medical Director and Clinical Leaders to implement population health strategies that improve care delivery and member outcomes.
  • Foster partnerships with healthcare providers, community organizations, and policymakers to promote a comprehensive approach to behavioral health.
  • Serve as a subject matter expert on behavioral health policies, advocating for changes that support the integration of mental health and substance use disorder services within the healthcare system.
  • Engage in advocacy efforts to reduce stigma around mental health issues and promote awareness of available services.
  • Utilize data analytics to monitor program effectiveness, prepare reports, and communicate outcomes to leadership and stakeholders.
  • Use your skills to make an impact.

Required Qualifications

  • Must reside in South Carolina.
  • An active and unrestricted Licensed Behavioral Health Professional in South Carolina, such as:
    • Licensed Clinical Social Worker (LCSW)
    • Licensed Professional Counselor (LPC)
    • Licensed Marriage and Family Therapist (LMFT)
    • Psychiatric Nurse Practitioner (PMHNP-BC)
    • Qualified Mental Health Professional (QMHP)
    • Clinical Psychologist or Psychiatrist
    • Other clinical license in behavioral health
  • Minimum of five (5) years of behavioral health practitioner experience.
  • Minimum of two (2) years in a leadership role managing behavioral healthcare operations.
  • Knowledge of the managed care industry and Medicaid, with familiarity in South Carolina-based behavioral health organizations.
  • Proven ability to engage and collaborate with healthcare providers and community stakeholders.
  • Excellent analytical and communication skills, with experience in data reporting and program evaluation.

Preferred Qualifications

  • Experience in Medicaid Managed Care clinical or behavioral health leadership which will include hiring, training, coaching and up to termination.
  • Familiarity with accreditation standards and contract requirements.

Additional Information

Workstyle: Remote work at home Location: Columbia, South Carolina Schedule: 8:00 AM to 5:00 PM Eastern Monday through Friday Travel: Less than 25%

Work at Home Guidance: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed...

Skills

Behavioral Health
Program Development
Data Analysis
Quality Measures
Population Health
Stakeholder Engagement
Policy Advocacy
Healthcare Collaboration

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.
Rising medical costs and tightening Medicare reimbursements may strain financial performance.
Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.
The company emphasizes inclusivity, offering free language interpreter services for accessibility.
Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.
The company is the first insurer to cover TMS therapy for adolescent depression.
Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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