Lead Director, Behavioral Health & Specialty Programs
Core
Lead strategy, implementation, and performance for Florida Medicaid and Florida Healthy Kids behavioral health and specialty populations, focusing on children and adolescents with complex needs.
Role type
Senior leadership director (health plan operations)
Builds
Integrated behavioral health and specialty-population programs for state Medicaid members
Domain
US Healthcare / Medicaid Managed Care / Behavioral Health
Required skills
Medicaid managed care strategy, behavioral health operations, population health management, provider network management, regulatory compliance, data analytics for health outcomes, vendor oversight, fraud waste abuse detection, stakeholder management
Preferred skills
Established relationships with Florida behavioral health and child welfare partners
Technologies
Claims data, authorization systems, pharmacy data, HIE, care-management platforms
Responsibilities
Develop and execute integrated Florida Medicaid behavioral health strategy; Coordinate care management, utilization management, pharmacy, and quality functions; Use data to identify gaps and improve access, engagement, and readmissions; Partner with Quality teams to drive measurable improvement in behavioral health outcomes; Serve as subject-matter expert for key providers and drive network strategies; Oversee BH vendors for clinical effectiveness and ROI; Monitor utilization and cost trends; Represent the health plan with state agencies and industry partners
Seniority
Director, strategic leadership