Senior Behavioral Health Program Lead (Hybrid-Remote)

Blue Cross NC; North Carolina; Hybrid; USD 89,000 - 143,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401k match

Paid time off

Tuition reimbursement

Parental leave and adoption assistance

Wellness programs

Job summary

Blue Cross NC is seeking a Sr. Behavioral Health Program Manager for the State Health Plan (SHP). You will own the BH portfolio, including utilization management, case management, care navigation, and ASD/ABA initiatives, aligning them with SHP commitments and BCBSNC strategy.

You will partner across clinical, enterprise, compliance, network, and vendor teams to improve access, ensure MHPAEA parity, and deliver measurable clinical and financial outcomes for members.

Qualifications

• Bachelor's degree or advanced degree required.
• 5+ years of experience in related field (or 7+ years in lieu of degree).

Responsibilities

• Own SHP BH portfolio governance and multi-year roadmap across UM, CM, Navigation, Appeals, Claims, and Customer Service.
• Lead implementation, process improvement, and change management through matrix teams.
• Monitor ABA utilization, spend, and outcomes; support integrated ABA UM and CM model.
• Support BH navigation processes with closed-loop referrals across digital partners and Care Management.
• Partner on parity, compliance and accreditation efforts with NCQA, NCDOI, and MHPAEA experts.
• Manage BH vendors and delegated entities with KPI monitoring and escalation paths.

Skills

Program governance

RAID management

Change management

Vendor management

Cross-functional collaboration

Analytics and reporting

Education

Bachelor's degree

Advanced degree

Job description

Blue Cross NC is seeking a Sr. Behavioral Health Program Manager for the State Health Plan (SHP). You will own the BH portfolio, including utilization management, case management, care navigation, and ASD/ABA initiatives, aligning them with SHP commitments and BCBSNC strategy.

You will partner across clinical, enterprise, compliance, network, and vendor teams to improve access, ensure MHPAEA parity, and deliver measurable clinical and financial outcomes for members.