Managed Care Behavioral Health Coordinator - Hybrid - Part-time

• Minimum high school diploma or equivalent; associate or bachelors degree in relevant field experience in lieu of education may be considered
• Community Health Worker (CHW) Certification specialty preferred such as a Peer Support Specialist (PSS); may consider highly qualified candidate willing to obtain CHW within one year of hire
• Experience with a similar population in health plan care management or managed care coordination
• Minimum 2 years administrative or coordinator experience in behavioral health and/or social services preferred
• Experience working with vulnerable populations in community medical or mental health setting and experience administering the OHP and Medicare benefits preferred

1. Collaborates with agencies and providers relating to behavioral health clinical training needs schedules and technical support
2. Responds to member and provider questions and concerns related to the behavioral health division
3. Ensures communication and followup among social service partners
4. Serves as an internal subject matter expert for Advanced Health and DOCS Management Services regarding the behavioral health service line
5. Works with Behavioral Health Director and Systems of Care (SOC) Specialist to coordinate provider trainings and events
6. Coordinates meetings among the relevant CCO staff providers collaboratives and other behavioral healthfocused groups as needed
7. Participate in quality improvement projects that support member provider and organizations strategic goals
8. Talk with members and providers by phone or in person handling inquires in a prompt courteous manner
9. Act as a member advocate and liaison with providers and partners as needed to ensure members are connected to services
10. Schedule System of Care Meetings coordinate the agenda with the SOC Specialist and take meeting minutes
11. Maintain and update System of Care Basecamp resources and sends community information to members
12. Ensuring compliance with company policies and procedures as applicable to area(s) of responsibility
13. Handling confidential information and materials appropriately and maintaining a secure work area
14. Utilize state local and internal data to drive agenda/conversations when applicable
15. Educate customers about health plan benefit structure and relevant policies and procedures as applicable
16. Represents the Behavioral Health Team through electronic telephonic and personal interactions with the public
17. Assists in collecting information for audits of the behavioral health review processes
18. Forward relevant information of members requiring special intervention to Advanced Health programs and partners
19. Perform prior authorization reviews at the direction of the Behavioral Health Director
20. Participate in quality and organizational process improvement activities and teams when requested
21. Ensure compliance with company policies and procedures as applicable to area(s) of responsibility
22. Handle confidential information and materials appropriately and maintain a secure work area
23. Other duties as assigned

• Participate in quality and organizational process improvement activities when requested
• Support and contribute to effective safety quality and risk management efforts by adhering to established policies and procedures maintaining a safe environment promoting accident prevention and identifying and reporting potential liabilities
• Openly clearly and respectfully share and receive information opinions concerns and feedback in a supportive manner
• Work collaboratively by mentoring new and existing coworkers building bridges and creating rapport with team members across the organization
• Provide excellent customer service to all internal and external customers which includes team members members students visitors and vendors by consistently exceeding the customers expectations
• Recognize new developments and remain current in care management and coordination best practice standards and anticipate organizational modifications
• Advance personal knowledge base by pursuing continuing education to enhance professional competence
• Promote individual and organizational integrity by exhibiting ethical behavior to maintain high standards
• Represent organization at meetings and conferences as applicable

• Understanding of principles of health care of populations
• Knowledge of OHP program requirements benefit package eligibility categories and Oregon Division of Medical Assistance Program (MAP) rules and regulations preferred
• Knowledge of the Oregon Health Authorities Coordinated Care Organization required metrics
• Understanding of basic concepts of managed care
• Understanding of mental health and substance use disorders and how they impact health
• Understanding of social determinants of health
• Knowledge and use of TraumaInformed language and principles preferred
• Understanding and use of Person First language and principals preferred
• Knowledge of community social service agencies preferred
• Critical attention to detail for accuracy and timeliness
• Ability to report to work as scheduled and willingness to work a flexible schedule when needed
• Proficient in Microsoft Office Suite and Windows Operating System (OS)
• Training in or awareness of Health Literacy Poverty Informed Systemic Oppression language access and the use of healthcare interpreters uses of data to drive health equity Cultural Awareness TraumaInformed Care Adverse Childhood Experiences (ACEs) Culturally and Linguistically Appropriate Service (CLAS) Standards and universal access
• Knowledge and understanding of how the positions responsibilities contribute to the department and company goals and mission
• Knowledge of federal and state laws including OSHA HIPAA Waste Fraud and Abuse
• Awareness and understanding of equity diversity inclusion and the equity lens: ability to analyze the unfair benefits and/or burdens within a society or population by understanding the social political and environmental contexts of policies programs and practices
• Excellent people skills and friendly demeanor
• Critical thinking skills of using logic and reasoning to identify the strengths and weaknesses of alternative solutions conclusions or approaches to problems
• Attention to detail and organization skills
• Ability to handle stress and sensitive situations effectively while projecting a professional attitude
• Ability to communicate professionally both conversing and written
• Ability to work with diverse populations and interact with people of differing personalities and backgrounds
• Sensitive to economic considerations human needs and aware of how ones actions may affect others
• Ability to organize and work in a sensitive manner with people from other cultures
• Poised; maintains composure and sense of purpose

Required Experience:

IC