Behavioral Health and Systems of Care Coordinator
Behavioral Health and Systems of Care Coordinator
Posted on :
29-08-2025
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1 Vacancy
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Job Description
We are currently hiring a Behavioral Health and Systems of Care Coordinator!If you are organizedIf you are organized have excellent communication and meeting facilitation skills are familiar with Systems of Care and integrated behavioral services and value being part of a team that makes a difference you may be the right person for the position!Apply today!
JOB SPECIFICATIONS
Classification:NON-EXEMPT Status & Schedule:PART-TIME MONDAY FRIDAY 8AM 5PM
Location:HYBRID local to Coos county or surrounding area Salary:$35 - $44.23/ HOURLY
Department:BEHAVIORAL HEALTHReports to:BEHAVIORAL HEALTH DIRECTOR Supervision Exercised:NON-SUPERVISORY
JOB SPECIFICATIONS
Classification:NON-EXEMPT Status & Schedule:PART-TIME MONDAY FRIDAY 8AM 5PM
Location:HYBRID local to Coos county or surrounding area Salary:$35 - $44.23/ HOURLY
Department:BEHAVIORAL HEALTHReports to:BEHAVIORAL HEALTH DIRECTOR Supervision Exercised:NON-SUPERVISORY
Job Purpose: Managed Care Licensed BH Clinician
This position will play a key role in the Behavioral Health department conducting Systems of Care work and performing Utilization Reviews to ensure the delivery of coordinated cost-effective and high-quality behavioral health services in compliance with the Oregon Health Authority (OHA) and Coordinated Care Organization (CCO) guidelines. This role focuses on integrating behavioral health care with physical and dental services promoting population health and addressing health equity ensuring all services meet the standards of patient-centered culturally competent care.
Qualifications Education & Experience
- Masters Degree in Social Work (MSW) or related field from an accredited institution.
- Current state licensure in any of the following specialties: Licensed Clinical Social Worker (LCSW) Licensed Professional Counselor (LPC) Licensed Mental Health Counselor (LMHC) Licensed Marriage and Family Therapist (LMFT) and Licensed Clinical Professional Counselor (LCPC) preferred.
- Minimum of 3 years of clinical experience preferably in behavioral health managed care or Medicaid populations.
- Experience with utilization review care management working with vulnerable populations or systems of care work within a CCO or Medicaid setting is preferred
Essential Responsibilities: Behavioral Health Program Support
Systems of Care Work:
- Collaborate with behavioral physical and dental health providers to integrate services and ensure continuity of care across disciplines.
- Coordinate behavioral health services with Patient-Centered Primary Care Homes (PCPCH) to deliver holistic patient-centered care for Oregon Health Plan members.
- Support the development and maintenance of systems that align with population health management strategies addressing care gaps improving patient outcomes and reducing unnecessary costs.
- Advocate for and implement care coordination strategies that prioritize health equity and culturally competent care reducing health disparities among diverse populations.
- Participate in the design of policies and programs that support coordinated care for high-risk and complex behavioral health cases.
Utilization Review
- Conduct utilization reviews to ensure that behavioral health services are provided in compliance with Medicaid regulations and reflect medical necessity and cost-effectiveness
- Ensure that all service authorizations billing and documentation meet the standards of the Oregon Health Authority (OHA) and CCO contractual obligations
- Collaborate with clinical staff to review and evaluate treatment plans ensuring proper documentation for payer reimbursement
- Identify and manage high-risk and complex patients working with the clinical team to optimize care utilization in line with population health initiatives
- Act as a liaison between the department and insurance providers facilitating clear and efficient communication regarding coverage decisions and authorization appeals
- Participate in quality and organizational process improvement activities and teams when requested
- Ensure compliance with company policies and procedures as applicable to area(s) of responsibility
- Handle confidential information and materials appropriately and maintain a secure work area
- Other duties as assigned
Essential Responsibilities: ORGANIZATIONAL TEAM MEMBER
- 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 co-workers 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
Knowledge Skills & Abilities:
- Strong understanding of CCO principles including integration of care population health management and health equity.
- Work closely with a multidisciplinary team including psychiatrists therapists case managers physical health providers and external partners to ensure coordinated and integrated care delivery.
- Maintain up-to-date knowledge of managed care regulations CCO contract requirements and evolving behavioral health and healthcare policies.
- Provide training and consultation to staff on utilization review processes CCO guidelines and managed care practices ensuring adherence to all regulatory standards
- Knowledge of evidence-based practices and requirements to evaluate existing standards and implement new procedures
- 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
- Critical attention to detail for accuracy and timeliness
- High degree of initiative judgment discretion and decision-making
- Ability to exercise sound clinical judgment independent analysis critical thinking skills and knowledge of health conditions to determine best outcomes for members
- 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 Trauma-Informed 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
Working Conditions:
This position must have the ability to remain in a stationary position occasionally move about inside the office to access office machinery printer etc. frequently communicate and exchange accurate information.
Work Condition: hybrid work
Employee generally works within the interior of an office or remote work from home environment.
Employee may travel locally and be responsible for own transportation. Out of area travel may be required on occasion.
Hours of operations and specific staff scheduling may vary based on operational need.
The office environment is clean with a comfortable temperature and moderate noise level.
Exposed to:
Onsite: Cold/heat controls close contact with employees and the public in office environment. Remote: Employee is responsible for maintaining a safe work environment that is conducive to successful productivity and work output.
Machines equipment tools and supplies used: Constantly operates a computer or other office productivity machinery such as postage machine fax copier calculator multi-line telephone system scanner.
May answer a high volume of telephone calls complete documentation and use computer programs to either obtain or record information.
Multiple Duties: Must be able to work under conditions of frequent interruption and be able to stay on task.
Other Information:
This job description is intended to provide only basic guidelines for meeting job requirements. This job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of DOCS Management Services employees. Other duties responsibilities and activities may change or be assigned at any time with or without notice.
Required Experience:
IC
Employment Type
Full Time
Key Skills
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