Senior Behavioral Health Program Leader - Hybrid/Remote

Blue Cross and Blue Shield of North Carolina; Durham (NC); Hybrid; USD 89,000 - 143,000; Full time

Benefits offered by this job

Work-life balance

Medical, dental, and vision coverage

Parental leave and surrogacy support

401k with company match

Tuition reimbursement

Job summary

Blue Cross and Blue Shield of North Carolina seeks a Sr. Behavioral Health Program Manager for the State Health Plan to lead the BH portfolio and align its roadmap with contractual commitments and strategic goals.

You will partner across clinical, compliance, and vendor teams to improve access, MHPAEA alignment, and outcomes while managing governance and program performance in a hybrid work environment with Durham headquarters.

Qualifications

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

Responsibilities

• Own the SHP BH portfolio and its multi-year roadmap aligned to SHP contractual commitments and BCBSNC strategy.
• Lead governance, RAID management, and leadership reporting; maintain SHP-specific BH policies and workflows across UM, CM, Navigation, Appeals, Claims, and Customer Service; lead implementation and change management through matrix teams.
• Support integrated ABA UM and CM model with BH clinical leaders and ABA staff; monitor ABA utilization, spend and outcomes.
• Support BH navigation processes with closed-loop referrals across digital partners, Customer Service, and Care Management.
• Partner with Compliance, Legal, and MHPAEA experts on parity and NQTL analyses; lead audit readiness for NCQA, NCDOI, and federal/state requirements.
• Represent BCBSNC with SHP, consultants, vendors, and providers; manage BH vendors and delegated entities through KPI monitoring and escalations.
• Define and track BH metrics for access, utilization, authorization timeliness, ABA outcomes, member experience, and cost of care.

Skills

Business Process Improvements

Implementation Management

Process Improvement Initiatives

Process Improvements

Project Management

Project Management Oversight

Project Performance Management

Project Plan Development

Resource Management

Resource Planning

Education

Bachelor's degree or advanced degree

In lieu of degree, 7+ years of experience in related field

5+ years of experience in related field

Job description

Blue Cross and Blue Shield of North Carolina seeks a Sr. Behavioral Health Program Manager for the State Health Plan to lead the BH portfolio and align its roadmap with contractual commitments and strategic goals.

You will partner across clinical, compliance, and vendor teams to improve access, MHPAEA alignment, and outcomes while managing governance and program performance in a hybrid work environment with Durham headquarters.