Director, Behavioral Health Program at Bright Health

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ABOUT THE ROLE

The Director, Behavioral Health will collaborate with clinical leaders to build and implement solutions that align with Bright’s overall clinical management strategy and deliver excellent compliance and medical cost results in alignment with Bright Health’s Care Partner strategic approach.
 
The Director, Behavioral Health is responsible for building and leading a team responsible for the execution of behavioral health clinical program and services, in close collaboration with Behavioral Health Medical Directors, and the Bright Health Network Development and Compliance teams. This is a senior role within Bright Health’s Clinical Leadership accountable for establishing and operating the new Behavioral Health team. This includes program development, design, outcomes measurement, and evaluation of programs for all lines of business. Leads the identification and initiation of process improvements and implementation of projects for new services, contract requirements, clinical outcomes and regulatory requirements. Develops and monitors training for compliance, market and operations growth and expansion as well as product development as it relates to behavioral health. 

YOUR RESPONSIBILITIES

  • Build, evaluate, lead, monitor and oversee Behavioral Health teams and solutions for utilization management and care management that yield industry-leading medical cost and quality outcomes while aligning with Bright’s Care Partner philosophy
  • Lead the development and implementation of compliance activities for Federal and State regulations including Mental Health Parity, as well as URAC and NCQA accreditation as they related to Behavioral Health
  • Oversees the development of reporting and contributes to the measurement and evaluation of ongoing behavioral health programs performance
  • Reports behavioral health program performance and operational updates to governance committees (i.e. UM, Quality Committees, Compliance)
  • Collaborate with Network Development, Compliance, and Clinical Leaders to establish clinical operational and policy strategies that enhance program performance and align with Bright Health’s core objectives, policies and values including clinical and financial outcomes, member engagement and satisfaction
  • Collaborate, coordinate and facilitate with the Clinical Delivery teams and any vendors or delegated entities for Care Management and Utilization Management to operationalize and execute clinical programs
  • Maintain communication with departmental leadership, with routine updates on operations, issues, concerns, and other pertinent information
  • Analyze trends and implement behavioral health initiatives based upon data provided through the reporting of utilization management, quality, and audit data
  • Identifies areas of opportunity for improving access to, and quality of, BH services for members
  • Coordinate and collaborate with other departments responsible for function aspects of behavioral health programs including Quality, Care Management, Care Navigation, Clinical Market teams, Claim Ops, Line of Business/Product leaders, Provider Network, Markets, Member/Provider Services and Broker/Enrollment services to identify opportunities to smooth the member and provider experience across programs

SUPERVISORY RESPONSIBILITIES

  • This position has supervisory responsibilities for members of the Behavioral Health program team

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • A Bachelor’s degree in a related field is required, Master’s degree is preferred
  • An RN, LCSW or other clinical licensure is preferred, but not required
  • Ten or more years of professional experience, including five years developing and/or managing clinical programs, products and services is required
  • At least two years of experience working within a utilization management and/or care management operation is required; Experience working in managed care setting preferred
  • Prior experience with URAC or NCQA accreditation is desired
  • Formal training in Six Sigma, LEAN or other project management techniques is a plus, but not required
  • Proficient in MS Office; strong analytical skills are required

PROFESSIONAL COMPETENCIES

  • Strong operational mindset and ability to use data to draw insights
  • Thrive and drive results in a collaborative environment
  • Strong ability to communicate in written and verbal presentations
  • Strong team leadership skills
  • Exceptional Organizational skills
  • Excellent Functional skills

ABOUT US
 
At Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.
 
We’re Making Healthcare Right. Together. 

We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!
 
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

BRIGHT ON!

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Technology we use

  • Engineering
  • Product
  • Sales & Marketing
    • .NETLanguages
    • C#Languages
    • JavaLanguages
    • JavascriptLanguages
    • PythonLanguages
    • ScalaLanguages
    • SqlLanguages
    • PowerShellLanguages
    • D3JSLibraries
    • ReactLibraries
    • ReduxLibraries
    • FlutterLibraries
    • ExpressFrameworks
    • Node.jsFrameworks
    • MongoDBDatabases
    • MySQLDatabases
    • PostgreSQLDatabases
    • InVisionDesign
    • SketchDesign
    • Lucid ChartDesign
    • Aha!Management
    • ConfluenceManagement
    • JIRAManagement
    • Microsoft ProjectManagement
    • Microsoft DynamicsCRM

Location

We are downtown at 515 Congress Avenue, right in the heart of downtown! Tons of restaurants and close to public transportation.
Making Healthcare Better For All At Bright Health
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An Insider's view of Bright Health

What’s the vibe like in the office?

The office has a relaxed and laid back vibe but people are very serious about their work - perfect!

Anthony

Data Engineer

What does your typical day look like?

My day is so varied, given how quickly we're growing, which is fulfilling for me. I have a good balance of strategic and tactical work in my day as well as time to focus and time to collaborate.

Jen

VP, Digital

What makes someone successful on your team?

A hard-working team player who thinks first and codes next is likely to learn a lot and quickly become a valuable member of the team. Lots of experience with some of our tooling is always nice, but if someone can't knowledge-share well or responds poorly to code reviews and other requests for collaboration, it'll be a tough fit.

Brian

Software Engineer 3

How do your team's ideas influence the company's direction?

We hire smart individuals who thrive on accomplishment and purpose. Our teams are exposed to the bigger picture through constant communication and dialogues – that encourages them to come up with innovative solutions to problems. We've made significant adjustments on our direction in technology and process that were initiated by the team.

Abdullah

VP, Engineering

What are Bright Health Perks + Benefits

Bright Health Benefits Overview

We have 3 different health insurance plans, all through Cigna (HDP, Premium HDP and PPO). We cover the majority of the cost for the employee and some cost for family. We have two dental plans and a vision plan as well. We have a Lifestyle Spending Account and options for HSA/FSA. We put 3% of your total earnings into your 401K plan and you are immediately vested. We have all the latest technology (Mac or Surface laptops – your choice) to use including standing desks. Fully stocked fridge with snacks and drinks.

Culture
Partners with Nonprofits
Friends outside of work
Eat lunch together
Daily sync
Open door policy
Team owned deliverables
Team based strategic planning
Group brainstorming sessions
Pair programming
Open office floor plan
Diversity
Dedicated Diversity/Inclusion Staff
Unconscious bias training
Someone's primary function is managing the company’s diversity and inclusion initiatives
Mean gender pay gap below 10%
Hiring Practices that Promote Diversity
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Bright Health employees can contribute up to $3500 annually to their FSA.
Disability Insurance
Dental Benefits
Vision Benefits
Health Insurance Benefits
Life Insurance
Wellness Programs
Bright Health is proud to offer a wellness stipend of $200/month to all employees!
Onsite Gym
Mental Health Benefits
Retirement & Stock Options Benefits
401(K)
We will put 3% of your total earnings into your 401K plan, even if you don't put anything in. It's a safe harbor contribution.
401(K) Matching
Bright Health provides employees with a 401(k) plan managed by Vanguard. We provide a ‘safe harbor’ non-elective contribution equal to 3% of your compensation, regardless of participation in the p
Performance Bonus
Child Care & Parental Leave Benefits
Generous Parental Leave
We provide up to 6 weeks of parental leave for the primary caretaker. We also provide 2 weeks of leave for the secondary caretaker.
Flexible Work Schedule
Bright Health provides employees with a flexible work schedule that includes Core hours, Flexible start and end times.
Remote Work Program
Family Medical Leave
Company sponsored family events
Bright Health sponsors family oriented events Annually.
Vacation & Time Off Benefits
Generous PTO
Paid Holidays
Paid Sick Days
Perks & Discounts
Casual Dress
Commuter Benefits
Stocked Kitchen
Happy Hours
Happy hours are hosted on occasion.
Relocation Assistance
Fitness Subsidies
Bright Health employees are eligible for discounts on several gym memberships.
Home Office Stipend for Remote Employees
Professional Development Benefits
Diversity Program
Lunch and learns
Cross functional training encouraged
Promote from within
Online course subscriptions available
Customized development tracks

Additional Perks + Benefits

Bright's primary goal is to offer employee benefits and perks that are as flexible as possible to meet each employee's unique needs!

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