Staff Manager/Behavioral Health Managed Care Organization Contract Manager (HSD/BHSD #10108661)

$29.58 - $47.33 Hourly

$61,531 - $98,449 Annually

This position is a Pay Band 75

Posting Details

This job posting may be used to fill multiple vacancies.

THIS POSTING WILL BE USED FOR ONGOING RECRUITMENT AND MAY CLOSE AT ANY TIME. APPLICANT LISTS MAY BE SCREENED MORE THAN ONCE.

Our Vision

• Every New Mexican has access to affordable health care coverage through a coordinated and seamless health care system.

Our Mission

• We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.

Our Goals

• Leverage purchasing power and partnerships to create innovative policies and models of comprehensive health care coverage that improve the health and well-being of New Mexicans and the workforce.
• Achieve health equity by addressing poverty, discrimination, and lack of resources, building a New Mexico where everyone thrives.
• Implement innovative technology and data-driven decision-making to provide unparalleled, convenient access to services and information.
• Build the best team in state government by supporting employees' continuous growth and wellness.

Why does the job exist?

The Staff Manager will:

• Provide contract oversight and management for behavioral health functions, services and requirements of the (Medicaid) Turquoise Care Managed Care Organizations (MCO) that are contracted to provide Turquoise Care;
• Serve as the primary point of contact for the MCO behavioral health contract related communications with MCO operations teams;
• Collaborate with Medical Assistance Division (MAD) staff and teams on behavioral health Turquoise Care contractual language, activities related to procurement, readiness reviews, contractual updates, revisions, audits, technical assistance to MCOs and any other MCO contractual tasks and related projects as needed;
• Provide direct support to the Behavioral Health Services Division (BHSD) leadership and program staff, the Health Care Authority (HCA) Medical Assistance Division (MAD), Office of Inspector General (OIG), Children Youth and Families Division (CYFD) and Department of Health as needed to collaborate contractual management and oversight.

How does it get done?

The Staff Manager is responsible for:

• Providing leadership and technical assistance to MCOs regarding behavioral health Medicaid Turquoise Care contract;
• Providing oversight of 1-4 Managed Care Organizations (MCO) Turquoise Care contractual agreements as it pertains to BHSD;
• Providing technical assistance to Managed Care Organizations, providers, and stake holders as it pertains to understanding and operationalization of Turquoise Care Contract, New Mexico Administrative Code (NMAC), Turquoise Care Policy Manual, and Behavioral Health Policy and Billing Manual to work toward resolutions of provider credentialing, billing, claims, and member issues;
• Providing expertise for MCOs and providers needing support navigating policies, procedures, and guidelines to administer contracted behavioral health services under Medicaid;
• Collaborating with BHSD, MAD, CYFD and Department of Health (DOH) staff on inquiries related to member and provider concerns, grievances and responses to Constituent Concerns to the Office of the Secretary and Governor's office;
• Participating in MCO meetings at/with BHSD and/or Medical Assistance Division (MAD) and/or Children Youth and Families Division (CYFD);
• Managing and tracking contract issues and outcomes with MCOs in the areas such as billing, deliverable requests, and letters of direction for the contract;
• Participating in audits, readiness activities and other Medicaid functions, workgroups, and projects as related to behavioral health Turquoise Care contract oversight and BH services;
• Participating in the 1115 Waiver renewal, monitoring and implementation activities and processes with MAD as needed.

Who are the customers?

• Health Care Authority (HCA);
• Behavioral Health Services Division (BHSD);
• The Behavioral Health communities;
• Medicaid Clients.

Ideal Candidate

The ideal candidate has:

• Ability to provide expert guidance to customers, staff, manager and other divisions and departments;
• Ability to collaborate and communicate with internal and external entities;
• Experience conducting research to obtain information and resolve issues;
• Strong verbal and written communication skills;
• Understanding of competing deadlines, strong multitasking skills, ability to prioritize and resolve complex issues timely;
• Management, organizational and interpersonal skills.

Minimum Qualification

A Bachelor's Degree in any field of study from an accredited college or university and five (5) years of professional level experience operating within parameters and guidelines directly related to the purpose of the position defined by the agency at the time of recruitment. Substitutions Apply. See Substitution Table below. A hiring agency will designate that a portion of the required experience to include supervisory and/or specialized experience. Any required licensure, certification or registration shall be defined at the time of recruitment and will be in addition to the above requirements.

Substitution Table

These combinations of education and experience qualify you for the position:
Education Experience 1 High School Diploma or Equivalent AND 9 years of experience 2 Associate's degree AND 7 years of experience 3 Bachelor's degree AND 5 years of experience 4 Master's degree AND 3 years of experience 5 PhD degree AND 1 year of experience
• Education and years of experience must be related to the purpose of the position.

• If Minimum Qualification requires a specific number of "semester hours" in a field (e.g. 6 semester hours in Accounting), applicants MUST have those semester hours in order to meet the minimum qualifications. No substitutions apply for semester hours.

Employment Requirements

Must possess and maintain a valid Driver's License.

Working Conditions

Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT) and extensive personal computer and phone usage.

Supplemental Information

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Agency Contact Information: Brenda Trujillo (505) 476-5664.

For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.

Bargaining Unit Position

This position is not covered by a collective bargaining agreement.