Behavioral Health Program Specialist-Healthy Families

CalOptima is a nationally recognized County Organized Health System that provides health insurance to over 300,000 Orange County, California residents through multiple product lines. Our mission is to provide our members with access to quality health care services delivered in a cost-effective and compassionate manner. BEHAVIORAL HEALTH PROGRAM SPECIALIST Responsibilities of this role include: Overall program design and implementation; development of necessary processes to access the mental health benefits for the Healthy Families Program (HFP); coordination of mental health services for the HFP members to ensure appropriate utilization with the health networks, mental health providers, and the County of Orange/Children and Youth Services; Serve as the primary resource to HFP members, primary care providers and health networks with regard to benefit coverage and referral processes for behavioral health services; Responsible for staffing the daytime 1-800 behavioral health resource line dedicated to provide information about available behavioral health care resources; Tracking and trending of mental health utilization data to monitor under/over-utilization. Function as a liaison within CalOptima and with external organizations to develop and maintain an informal mental health/social services network of community resources to support behavioral health services. Establish effective working rapport with HFP members, their families, co-workers, community advocates and contractors. Assist the family in understanding the members’ physical or behavioral health problems. Comply with the HFP and Department of Managed Health Care Regulations. Some travel offsite will be required.
REQUIREMENTS
This position requires a Bachelor’s in Social Science or related field. Master’s degree preferred. At least 3 years experience in a behavioral/mental health field, program development and outcomes measurement; supervisory or managerial experience preferred. Knowledge of the Medi-Cal/Healthy Families Program preferred. Understands confidentiality and the legal and ethical issues pertaining to case management. Bilingual in Spanish is a must. CalOptima offers an excellent work environment that includes flexible scheduling plans, a highly competitive benefits package and an organizational mission that drives our employees to excel!