Job Description

Location :  Hybrid : Most of the positions at YCCO are hybrid, meaning they have the flexibility to work both remotely and in-person at YCCO's office in McMinnville, OR.

Department: Health Plan Operations FLSA Status: Exempt (Salaried)

Division: Health Plan Operations Physical Strength: Light (L)

Reports To: Behavioral Health Director Work Location Type: Hybrid

Supervisory Role: No Occasional Weekend Work: No

About Us: Yamhill Community Care  is a nonprofit coordinated care organization dedicated to managing the healthcare for Medicaid members, covered under the Oregon Health Plan, in Yamhill County, as well as parts of Washington and Polk Counties. Our mission is to improve the quality of life of the communities we serve by coordinating effective care. Beyond healthcare, we also provide an Early Learning Hub, supporting families and children with essential resources and programs for early childhood development. Together, we're building a unified healthy community that celebrates physical, mental, emotional, spiritual, and social well-being.

Learn more about Yamhill Community Care: click here

Summary

The Behavioral Health Systems Innovation Specialist is responsible for supporting the development and management of the Yamhill Community Care (YCCO) Behavioral Health network and ensuring quality services and supports are available for its members and the community. This position is instrumental in ensuring the performance of YCCO under its Oregon Health Plan (OHP) managed care contract and works to build and sustain access to quality Behavioral Health care and services. 

Essential Duties

1. Collaborates in the development and maintenance of a comprehensive health service delivery system that provides high quality and cost-effective service to YCCO members.
2. Provides Behavioral Health subject matter expertise and cross team collaboration in support of contract deliverables and system improvement efforts. 
3. Develops initiatives and process improvement in collaboration with stakeholders to ensure compliance with contract requirements including, but not limited to, access, quality, program integrity, quality of clinical care, utilization, and compliance with Oregon Administrative Rules (OAR) and other regulatory standards, as assigned.

Job Duties

• Provides clinical expertise and advice for internal quality and care coordination activities, community collaboration meetings, and in multidisciplinary settings to support members with complex Behavioral Health needs.
• Actively follows Behavioral Health best practices and professional code of conduct / ethics.
• Provides content expertise and technical assistance to YCCO’s internal teams as well as external provider organizations.
• Develops trust / credibility and collaborates with YCCO providers and other community partners.
• Promotes effective communications within YCCO and with external partners and providers.
• Reviews and analyzes the provider network and systems and identifies opportunities for network enhancement and technical support or education needs.
• Responsible for leading improvement plans and projects related to assigned functional areas.
• Ensures YCCO meets Behavioral Health contract deliverables including creation of necessary reports, policies and procedures, and other documents as necessary.
• Adheres to YCCO policy and procedures and standards of operations.
• Writes / revises policies and procedures, prepares reports, and other documents as needed.

Essential Department & Organizational Functions

• Works to cultivate and develop inclusive and equitable services, and working relationships with diverse groups of employees, community partners, and community members.
• Participates in the preparation and submission of regulatory and contract required deliverables.
• Works closely with other YCCO departments, including Compliance to assist with audits; including the External Quality Review (EQR), as needed.
• Proposes and implements process improvements.
• Meets deadlines for completion of assigned responsibilities and projects.
• Maintains agreed upon work schedule with punctual, regular, and predictable attendance.
• Attends in person Annual Company Conference in Oregon; typically held in the fourth week of September.
• Demonstrates cooperation and teamwork using a professional and respectful demeanor.
• Provides cross-training on specific job responsibilities.
• Meets identified goals that contribute to departmental goals.
• Respectfully takes direction from Supervisor.
• Performs other duties as assigned.

Knowledge, Skills, & Abilities

• Knowledgeable in managed care, OHP benefits, Behavioral Health Systems, OAR, Oregon Statute (ORS), and CCO requirements.
• Strong organizational skills with the ability to manage multiple tasks / projects simultaneously.
• Strong report and policy development and writing skills.
• Ability to communicate project status and issues to Director in a timely manner.
• Ability to build productive working relationships, problem-solve and resolve conflicts successfully.
• Ability to work in transformational systems.
• Excellent verbal and written communication, facilitation, and customer service skills.
• Ability to use critical thinking skills in problem solving.
• Ability to build and maintain professional relationships with community stakeholders.
• Skills in project management, group facilitation, community organizing and systems-thinking.
• Possess a high degree of initiative and motivation along with the ability to effectively collaborate and plan with others.
• Ability to focus on and comprehend information, learn new skills / abilities, assess situations, and determine appropriate resolution, accept direction, and feedback, and manage stress.
• Excellent organizational skills including the ability to handle multiple priorities and demands simultaneously in a dynamic work environment while maintaining high attention to detail and accuracy.
• Ability to work independently, use sound judgment, anticipate next steps and be proactive as part of a diverse team within a Matrix (cross-department) or shared resources across departments work model with a spirit of cooperation.
• Excellent computer skills, including Microsoft Windows, Word, Excel, and Outlook.
• Ability to communicate both professionally and effectively in all forms of communication.
• Ability to work in an environment with diverse individuals and groups.
• Ability to remain flexible, positive, and adaptable.
• Ability to work across the YCCO region and to work remotely, as needed.

Supervisory Responsibilities

This position has no supervisory responsibility. 

Qualifications

Ability to perform essential job duties with or without reasonable accommodation and without posing a direct threat to safety or health of employee or others. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above and below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

Education & Experience

Required :

• Master’s degree in Social Work, Counseling, or related Healthcare field,
• A minimum of three (3) years of related experience, 

OR:

• Any combination of education and direct experience that would qualify the candidate for the position.

Preferred :

• At least five (5) years of experience in Community Behavioral Health direct service with a focus on Substance Use Disorder (SUD) service programs,
• Experience working with the Oregon Health Plan.

Certificates, Licenses and/or Registrations

Preferred : Valid, unrestricted in the state of Oregon

• Certified Alcohol and Drug Counselor (CADC),
• Licensed Clinical Social Worker (LCSW),
• Licensed Professional Counselor (LPC),
• Licensed Master of Social Worker (LMSW),

OR:

• Equivalent license. 

Physical Demands & Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this position. The work environment characteristics described here are representative of those an employee encounters while performing the essential duties of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit, stand, walk, use hands and fingers, handle or feel, and reach with hands and arms. The employee is occasionally required to climb or balance, stoop, kneel, crouch or crawl. The employee may occasionally need to lift and/or move up to 25 pounds.

This position operates in a professional office environment and requires frequent use of standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Specific vision abilities required by this job include close vision, color vision, distance vision, depth perception, and ability to adjust focus. The noise level in the work environment is usually moderate. 

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