PacificSource Health Plans · 4 hours ago
CCO Behavioral Health Director
Springfield, OR
Full-time
Onsite
Mid, Senior Level
$108K/yr - $184K/yr
5+ years expPacificSource Health Plans is dedicated to helping members access quality, affordable care. The CCO Behavioral Health Director is responsible for leading the development and implementation of behavioral health transformation strategies for Medicaid enrollees, collaborating with various stakeholders to ensure access to comprehensive behavioral health services.
CommunitiesCustomer ServiceNon Profit
Responsibilities
Identify opportunities to develop, strengthen, and expand access to robust, high value evidence based behavioral health services within assigned service areas, including all sectors of care delivery (e.g., primary care, specialty, hospital, dental, and community-based settings) in direct partnership with CCO Directors
Accountable for strategic development, implementation and oversight of a multi-year BH transformation and improvement strategy by leading efforts in collaboration with internal and external stakeholders such as Care Management, Population Health, Quality Improvement, and Provider Network along with providers and community partners (Regional CBHP)
Lead development and oversee operationalization of integrated, outpatient, specialty and residential behavioral health strategies, along with programs that integrate physical and behavioral health
Manage key external relationships, create new innovative collaboration and integration opportunities, and serve as a key leader for provider interests, commitments, resource requirements, timelines and related action items relating to Behavioral Health
Serve as a BH matrixed leader to integrate BH into Compliance, Contracting, Provider Relations, Quality Improvement, Care Management, Utilization Management, Population Health, Training, and Provider Network
Represent the company in each CCO as subject matter expert and BH specialty leader, including informing BH training and education as needed
Remain informed and offer consultation regarding compliance to federal and state regulatory requirements related to behavioral health in each CCO, including activities performed within PacificSource and in conjunction with critical community providers
Collaborate to develop and deploy components of workforce plans, health equity plans, training plans, Transformation and Quality Strategy initiatives, and quality improvement initiatives
Oversee operationalization of community BH programs and services, including Wraparound, System of Care governance, ACT, mobile crisis, supported employment, etc
Demonstrate ability to successfully navigate in a matrixed organization, a history of executing in a fast-paced environment, and ability to remain accountable for deliverables while working in partnership with others throughout the organization
Analyze and interpret data in collaboration with other departments to identify opportunities for improved outcomes and cost savings across the continuum of care, and make recommendations for innovative BH initiatives and integrated health strategies
Actively lead or participate in various internal and external committees in order to provide behavioral health expertise and perspective, disseminate information, and promote BH transformation and improvement strategies
Responsible for the oversight, development, implementation and review of behavioral health plans, policies, procedures and other guidelines
Coordinate with other departments to understand and deploy needed BH clinical strategies as dictated by evidence-based criteria, legislation and parity needs
Utilize Lean methodologies to identify process improvement and cultivate a culture of continuous improvement
Partner with Provider Network with strong knowledge of contracting process and effective strategies to promote BH outcomes, including performance metrics in furtherance of VBPs
Work closely with the BH Medical Director (via matrix reporting) to execute the vision and plans for BH services
Supports cost and utilization portfolio for BH within the assigned CCOs
Supports financial performance of innovative strategies and treatment models through strategic shared risk/reward contracts with key provider partners
Recommends budgets in alignment with short and long-term plans
Works with department leadership in responding to inquiries or complaints to the Oregon Health Authority or other regulatory agency, preparing reports for other review functions, and addressing grievances and appeals
Advises the Company regarding the appropriateness of reimbursement for services, considering diagnosis, and contract provisions
Coordinates business activities by maintaining collaborative partnerships with key departments
Meets department and company performance and attendance expectations
Follows the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information
Performs other duties as assigned
Qualification
Required
Minimum 5 years' experience in a behavioral health or behavioral health plan setting required, including at least 3 years in people management and/or leadership positions
Demonstrated knowledge and experience with program development
Demonstrated execution of complicated initiatives in a matrixed environment
Advanced clinical degree in behavioral health (mental health and/or substance use disorders)
Licensed Clinical psychologist, LCSW, LPC, LMFT, or comparable behavioral health professional with extensive experience preferred
Thorough knowledge and understanding of medical and behavioral procedures, diagnoses, treatment modalities, procedure codes, including ICD-9 & 10, DSM-5, ASAM-PPCR-5, HCPCS and CPT Codes, health insurance and mandated benefits (including those provided by a wide array of community partners) within Oregon and the Pacific Northwest
Thorough knowledge of community services, providers, vendors and facilities available to assist members
Ability to use computerized systems for data and document recording and retrieval
Maintain current clinical knowledge base
Proficient in the use and implementation of the following tools and concepts across all teams within scope of accountability: Strategy Deployment, Daily Operations, Visual Management, Operational Improvement, auditing
Accountable leadership, Business & financial acumen, Empowerment, Influential Communications, Situational Leadership, Strategic Planning
Preferred
Experience working with Oregon Medicaid and/or OHP behavior health benefits preferred
Company
PacificSource Health Plans
Founded in 1933, PacificSource is a not-for-profit health insurer for people and organizations throughout the Northwest.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
John Espinola MD MBA
President and CEO
Erick Doolen
Chief Operating Officer
Recent News
2025-11-29
2025-10-22
Company data provided by crunchbase