Behavioral Health Community Partnership Manager
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Eureka • California • United States
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Salary
💰 $75,920 - $113,880 per year
About the role
- Establishes relationships and engages with BH providers and ensures measurable improvements in clinical and quality outcomes for members.
- Builds relationships with internal clinical and quality departments to ensure high-quality care to members and achievement of company HEDIS performance.
- Implements strategies that meet clinical, quality, and network improvement goals.
- Build positive working relationships with providers, state agencies, advocacy groups, and other market stakeholders.
- Meets routinely with strategic providers face to face, telephonically, and via Web-Ex to support provider training on Carelon processes, contracting/credentialing and linkages for issue resolution, helping to improve provider experience and overall satisfaction with Carelon.
- Acts as a liaison between strategic providers and Carelon clinical, quality, provider strategy, operations, and claims, to ensure interdepartmental collaboration and coordination of goals and priorities.
- Supports regional and corporate initiatives regarding Carelon Select Provider (CSP) program, clinical innovation, and thought leadership transforming provider relationships from transactional interactions to collaboration.
- Creates and maintains linkages between providers of all levels of care, as well as other community-based services and resources to improve transitions of care and continuity of services.
- Partners with network providers and Carelon stakeholders to operationalize innovative programs and online resources to improve clinical and quality outcomes.
- Analyzes provider reports pertaining to cost, utilization, and outcomes, and presents the data to providers and highlights trends.
- Identifies data outliers and opportunities for improvement for individual providers.
- Identifies high-performing and innovative providers who may be interested in new programmatic incentives or payment models.
- Participates in the identification of opportunities for expansion and development of innovative pilot programs, implementation, launch, and efficacy and outcomes measurements.
- Provides consultation to providers for clinically complex members as applicable.
- Surfaces clinical and quality issues to regional clinical and quality teams and participates in helping to address concerns.
- Conducts quarterly physician record reviews or as needed with network providers across all service levels.
- Assists with provider orientations and provider training events in the region, when applicable.
- Attends all accessible County BH provider meetings either in person or via telephone or Web-ex.
Requirements
- MA/MS or above in Behavioral Health field
- minimum of 10 years of progressively responsible professional experience in healthcare
- minimum of 5 years’ experience in a behavioral health setting
- Current, valid, independent, and unrestricted license such as RN, LCSW, LMFT, LMHC, LPC, or Licensed Psychologist
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
- Paid Time Off
- medical, dental, vision benefits
- short and long term disability benefits
- wellness programs
- financial education resources
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analysisclinical outcomes improvementquality outcomes improvementprovider trainingprogram developmentpilot program implementationutilization managementHEDIS performanceconsultation for complex membersrecord review
Soft Skills
relationship buildinginterdepartmental collaborationcommunicationproblem-solvingstakeholder engagementleadershipstrategic thinkingtraining facilitationnegotiationadvocacy
Certifications
RNLCSWLMFTLMHCLPCLicensed Psychologist