Behavioral Health Clinical & Quality Assurance Strategist

The Behavioral Health Clinical & Quality Assurance Strategist will serve as a clinical and strategic lead within the Medicaid Division. Through the sound application of clinical evidence and best practice in behavioral health clinical review and OHP policy interpretation, this position will promote access to high quality behavioral health services and pursue the quintuple aim of health equity, better health, improved outcomes, lower costs, and clinician well-being.

This position will provide internal and external leadership and direction of OHP behavioral health policy through collaboration with the Medicaid Medical Leadership Team, the Behavioral Health Division, and the Health Policy and Analytics Division on various projects. This position serves as a subject matter expert on OHP benefits and policy, OHA behavioral health rules, and federal Medicaid regulations. They will advise and coordinate with Medicaid contractors, provide technical assistance to OHP enrolled behavioral health providers, influence statewide OHP program integrity, and support cross-divisional and interagency initiatives.

This position will be responsible for reviewing prior authorizations, Notices of Action (NOA), adverse determinations made by the Independent Qualified Agent (IQA), and any other documentation needed to determine the appropriate level of service for adult Medicaid Beneficiaries.

This position will collaborate with diverse populations most harmed by social injustice and inequities and will demonstrate the ability to build and steward positive, collaborative and partnership-based relationships with diverse community groups including communities of color, immigrant groups, the disability and neurodivergent communities, veterans, older adults, individuals identifying as LGBTQIA2S+ and other communities that have been traditionally marginalized.

This announcement is for one, full-time, permanent, non-represented management service, Operations & Policy Analyst 4 position based in Salem, Oregon.

This is a HYBRID/(15% IN-OFFICE) position. Please check SECTION 4. WORKING CONDITIONS, of the position description linked above to review more details regarding the details surrounding the working conditions.

Benefits of Joining Our Team

• Excellent medical, vision, and dental benefits package for the employee and qualified family members with a very low monthly out-of-pocket cost.
• Optional life insurance, short-term disability, long-term disability, deferred compensation savings program, and flexible spending accounts for health care and childcare expenses.
• Employee benefits include 11 paid holidays, 3 personal business days, 8 hours of monthly sick leave, and vacation accrual starting at 8 hours per month.

• Possible eligibility for the Public Service Loan Forgiveness Program.

• Membership in the Public Employees Retirement System (PERS)/Oregon Public Service Retirement Plan (OPSRP).

• Training opportunities that will help grow your career with the State of Oregon.

What We Are Looking For

Minimum Qualifications:

Any combination of experience and education equivalent to eight years professional-level evaluative, analytical and planning work.

Special Qualifications:

Active clinical Oregon licensure through one of following licensing boards: The Oregon Medical Board, The Board of Licensed Social Workers, The Oregon Board of Licensed Counselors and Therapists, The Oregon State Board of Nursing Licenses, or The Health Related Licensing Boards.

Desired Attributes: The following are skills and lived experiences that we have identified as key to success in this role at OHA. These are the attributes we are looking for in our top candidate. If you possess any of these, please let us know in your application.

• Experience leading or supporting the development and implementation of policies and programs. 
• Knowledge of health services delivery systems, particularly the Oregon Health Plan/ Medicaid administration in Oregon, Coordinated Care Organizations, social safety net programs, health service providers (including Community Mental Health Programs and other behavioral health service providers), and community-based organizations.
• Knowledge of legislative and regulatory processes.
• Clinical experience working across multiple levels within the behavioral health continuum of care. Experience with individual patient advocacy and supporting the acquisition of medically necessary health services.
• Ability to provide organizational leadership. Ability to navigate complex relationships through collaborative problem-solving, consensus-building, and solution-focused approaches, recognizing positionality and fostering power-sharing dynamics. Experience facilitating meetings.
• Strong oral and written communication skills across a variety of forums; experience communicating qualitative and quantitative information, verbal and written.

How to Apply: Submit application with your resume and cover letter to Oregonjobs.org using job number REQ-181420

 Application Deadline:  6/11/2025

Salary Range:  $7,353 - $10,827

How to Apply: Submit application with your resume and cover letter to Oregonjobs.org using job number REQ-181420

 Application Deadline:  6/11/2025