Candidates hired for remote positions must reside in Oregon or Washington.

Job Summary

The Behavioral Health Quality Metrics Manager manages the operations, projects, and planning for the department's Behavioral Health Quality Improvement Analytics team. The team is responsible for analyzing, monitoring, reporting, and providing technical collaboration on behavioral health clinical quality metrics including Oregon Health Authority (OHA) Incentive Metrics, Performance Improvement Projects, and other clinical quality programs. This position monitors staffing and resource needs, develops staff members, and leads process improvement efforts. Additionally, the position participates in OHA quality committees and works with the Director of Analytics and Evaluation on plan-wide quality improvement and data strategy activities. The position assists in developing a long-term plan for the department to support the needs of the organization, including enterprise data and analytics solutions.

Essential Responsibilities

Technical Leadership

• Lead behavioral health-related quality improvement analytics activities related to metrics, including OHA's CCO Incentive Metrics and other measures of health outcomes.
• Provide leadership in quality, cost, evaluation, and regulatory reporting.
• Oversee submission of regulatory deliverables to Oregon Health Authority and Centers for Medicare and Medicaid Services.
• Perform ongoing analysis of data relevant to the functional areas of the unit.
• Identify, propose, and implement opportunities for process improvements and develop improvement plans.
• Study and analyze tables, graphs, charts, and report results in various formats.
• Keep abreast of best practices in clinical quality measurement and incorporate these practices into the team's work.
• Ensure unit work is integrated and performing in coordination with other relevant CareOregon departments.
• Support directors in the ongoing strategic direction for the Network and Clinical Support (NCS) department.
• Represent CareOregon Informatics and Evaluation team at internal and external partner meetings related to clinical quality improvement and data analysis.

Planning

• Develop and implement policies and procedures that comply with Medicaid/Medicare regulations.
• Participate in the planning, design, and implementation of new analytic methodologies.
• Assist the Director, Analytics and Evaluation with short-term and long-term delivery system improvement planning.
• Provide recommendations to senior management on strategies for meeting performance goals.
• Assists management with team budget development and monitoring.

Employee Supervision

• Manage team and recommend team direction and goals in alignment with the organizational mission, vision, and values.
• Identify work and staffing needs to meet work expectations; recruit and hire, using an equity, diversity, and inclusion lens.
• Plan, organize, schedule, and monitor work; ensure employees have information and resources to meet job expectations.
• Lead the development, communication, and oversight of team and individual goals; ensure goals, expectations, and standards are clearly understood by staff.
• Train, supervise, motivate, and coach employees; support employee development.
• Incorporate guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, and decision-making.
• Ensure team adheres to department and organizational standards, policies, and procedures.
• Evaluate employee performance and provides regular feedback to support success; recognize strong performance and address performance gaps and accountability (corrective action).
• Perform supervisory tasks in collaboration with Human Resources as needed.

Organizational Responsibilities

• Perform work in alignment with the organization's mission, vision and values.
• Support the organization's commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
• Strive to meet annual business goals in support of the organization's strategic goals.
• Adhere to the organization's policies, procedures and other relevant compliance needs.
• Perform other duties as needed.

Experience and/or Education

Required

• Minimum 5 years' progressive experience in a quality improvement, analytics, research, or related work
• 1 year of experience in a healthcare data domain (e.g., Claims, Behavioral Health, Pharmacy, Clinical, Dental, etc.)

Preferred

• Minimum 2 years' experience in a supervisory position or minimum 1 year experience in a supervisory position with completion of CareOregon's Aspiring Leaders Program
• Experience working with the Oregon Health Plan (OHP) benefit, the Oregon Health Authority (OHA) and/or the Centers for Medicare and Medicaid Services (CMS) rules and regulations
• Master's or Bachelor's degree in STEM, Finance, Economics, Business Administration, Public Health, Management Information Systems, Computer Science, or related degree helpful

Knowledge, Skills and Abilities Required

Knowledge

• Knowledge of managed care concepts and principles
• Knowledge of health plan regulatory reporting requirements of Medicaid and Medicare managed care
• Knowledge of basic health plan operations
• Knowledge of best practices in data visualization
• Strong knowledge of operationalizing quality improvement and process improvement concepts, principles, and practices

Skills and Abilities

• Ability to support and comply with organizational policies, procedures, and guidelines

• Ability to provide leadership to groups of people and the implementation of projects
• Ability to manage multiple tasks, complex projects and to delegate as deemed appropriate
• Excellent reading, oral and written communication skills
• Excellent problem-solving and decision-making skills
• Excellent interpersonal skills
• Ability to work well under pressure in a complex and rapidly changing environment
• Ability to work independently
• Ability to mentor individual growth
• Strong data analysis and computer skills required, including word processing, spreadsheet, and database (i.e., Microsoft Office programs, Tableau, SPSS, SAS, or other statistical software)

• Ability to work effectively with diverse individuals and groups

• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, hear, speak clearly, and perform repetitive finger and wrist movement for at least 6 hours/day

Working Conditions

Work Environment(s): Indoor/Office Community Facilities/Security Outdoor Exposure

Member/Patient Facing: No Telephonic In Person

Hazards: May include, but not limited to, physical and ergonomic hazards.

Equipment: General office equipment and/or mobile technology

Travel: May include occasional required or optional travel outside of the workplace; the employee's personal vehicle, local transit or other means of transportation may be used.

#Li-Remote

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.

Veterans are strongly encouraged to apply.

We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.

Visa sponsorship is not available at this time.