Chief Behavioral Health & Quality Officer

About the Role

Chief Behavioral Health & Quality Officer at PHP Administrative in Anywhere. Lifestyle: remote, flexible schedule. Benefits: 401k, health benefits, PTO.

Work-Life Balance Factors

Remote/telehealth

Key Responsibilities

• Ensure compliant operation of PHP’s Children in State Custody program and manage reputational risk.
• Build and maintain outreach strategies with key stakeholders, including providers and community organizations.
• Excellent leadership, communication, and internal and external stakeholder management skills. Preferred Qualifications:
• Excellent leadership, communication, and internal and external stakeholder management skills
• Ensure compliant operation of PHP’s Children in State Custody program and manage reputational risk
• Build and maintain outreach strategies with key stakeholders, including providers and community organizations

Requirements

• Bachelors degree required
• Demonstrated experience leading risk adjustment operations and analytics for one or more lines of business.
• Certification(s): CRC (Certified Risk Adjustment Coder) or CPC, plus clinical coding and compliance training.
• Hands-on experience with encounter data submissions (e. g., EDS/EDPS/RAPS) and error remediation.
• Demonstrated experience leading risk adjustment operations and analytics for one or more lines of business

Benefits & Compensation

• Develop proactive monitoring processes for CISC and behavioral health contractual requirements.
• Identify opportunities and risks related to behavioral health priorities and lead responsive initiatives.
• Oversee behavioral health vendor performance, ensuring integration of clinical services and contractual compliance.
• Lead implementation of behavioral health initiatives, including crisis continuum and clinical programs.
• Collaborate with VP Population Health & Quality and Chief Medical Officer to advance integrated care models.
• Develop and maintain a statewide behavioral health network.