Healthfirst

The Director HARP (Health and Recovery Plan) Care Management is a visionary and strategic leader who oversees the design, delivery, and integration of physical and behavioral health care management for a population of HARP members with complex mental health, substance use, and chronic medical needs. This high-impact role is at the forefront of advancing our whole-person care model and driving transformation in how we deliver equitable, member-centered care. The Director guides a multidisciplinary team including licensed clinical social workers and registered nurses while playing a pivotal role in bridging clinical operations, population health analytics, and value-based performance strategy. As a member of the Behavioral Health leadership team, the Director is positioned as a key leader deeply involved in organizational planning, innovation, and policy leadership.

Duties/Responsibilities:

• Lead, mentor, and support the HARP Care Management team, ensuring high clinical quality, member satisfaction, and employee engagement
• Drive innovation in integrated care models that align with NYS Medicaid requirements and Healthfirst’s quality and value-based care goals
• Champion initiatives that elevate the integration of behavioral health with physical health and social determinant support services
• Design and implement efficient and effective clinical programs, workflows, and policies that address the comprehensive needs of HARP members, including transitions of care and housing support
• Evaluate program outcomes, identify gaps in care, and implement performance improvement strategies using clinical, utilization, and quality data
• Partner with departments across Healthfirst, including Medical Management, Population Health, Clinical Quality, Delivery Systems Engagement (DSE), and Analytics & Reporting, to ensure coordination of member care
• Serve as the clinical subject matter expert on business development efforts related to behavioral health programs, including the launch of new products or regulatory initiatives
• Act as a public-facing clinical leader with community partners, state agencies, and provider organizations
• Represent Healthfirst on local, state, and industry workgroups, helping to shape behavioral health best practices
• Ensures all NY state and federal compliance, audit and regulatory requirements are met
• Perform other duties as necessary or assigned     

  

Minimum Qualifications:

• NYS license as a Psychiatric-Mental Health Nurse Practitioner (PMHNP), or Licensed Clinical Social Worker (LCSW), or Licensed Master Social Worker (LMSW)
• 7 years of behavioral health experience in managed care and/or a clinical setting with at least 2 years of that experience being in managed care
• Progressive leadership experience in medical and behavioral health care management including work experience in a senior management role
• Work experience and deep familiarity with New York State HARP, HCBS, and Medicaid Managed Care programs

 Preferred Qualifications:

• Clinical and leadership experience as a Psychiatric-Mental Health Nurse Practitioner (PMHNP)
• Proven ability to lead complex teams and manage interdisciplinary care models in a health plan or integrated delivery system
• Demonstrated experience with regulatory compliance, clinical quality improvement, and care management
• Advanced proficiency in Microsoft Office (Word, Excel, PowerPoint) and ability to leverage data to inform strategy
• Exceptional written, verbal, and presentation skills; capable of influencing internal and external stakeholders
• Strategic thinker with strong operational discipline and capacity for executive-level decision-making

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $150,800 - $230,690

• All Other Locations (within approved locations): $124,400 - $190,315

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.