Senior Behavioral Health Program Specialist - Hybrid (PA/NJ/DE)
Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.
Responsibilities:
The Sr Behavioral Health Program Specialist leads initiatives and programs to enhance access, quality and value in across the IBX organization.
Supports behavioral health leadership in implementing initiatives in multi-year strategy to enhance behavioral health services and programs, including access strategies, digital navigation, related technology initiatives.
Serve as subject matter expert in the development, design, strategy alignment and implementation, of existing and new BH value-based performance initiatives to improve clinical and quality outcomes.
Lead efforts to develop a BH provider continuous improvement model
Works throughout the organization and with IBX Population Health group to integrate behavioral health measures into current and future quality improvement initiatives, demonstrating knowledge of HEDIS/STARS measures and experience in driving improvement.
Supports continuous assessment of network needs for gap closure both locally & OOA
Partners with analytics and data leaders to formulate/ capture and utilize BH data, spanning introductory projects through advanced analytic initiatives, championing innovation and quality improvement in BH programs through outcomes reporting and data insights.
Utilizes experience with continuous quality improvement methodologies to identify and support BH initiatives focused on reduction in cost and improvement in quality and experience.
Works collaboratively with product management team; consults and supports identification and implementation of BH product opportunities.
Qualifications - Qualifications & Education
Bachelor’s degree with minimum 5 years in progressive advancement in MBHO setting, master’s degree in behavioral health-related field, preferred. Master’s degree plus MBHO experience strongly preferred.
Prior experience in BH case management, utilization management, provider relations preferred
Experience, Knowledge, and Skills
5 + years’ experience working in a human service, behavioral health, MBHO setting
Demonstrated knowledge and experience with behavioral health quality measurement and improvement including BH HEDIS® measures
Deep understanding of integrated behavioral health care /whole health models
Project management competencies, must have strong knowledge of Microsoft Office products (Outlook, Word, Excel, and PowerPoint)
Experience in Lean, Six Sigma, TQI, TQC or other quality management certification
Ability to manage multiple priorities/projects effectively with limited supervision
- Strong quantitative, analytical, and time management skills
- Knowledge of medical billing, claims processing systems, and health care information terminology preferred
- Strong verbal and written communication skills including but not limited to effective group presentations to professional staff and management.
- Embrace the diversity of our workplace and show respect for colleagues internally and externally
Hybrid
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Vaccination Update
This job requires that you demonstrate you have been fully vaccinated for COVID-19 prior to the start of employment, to the extent permitted by law.
About Our Company
AmeriHealth Casualty has been successfully returning employees to work since 1994, providing quality medical treatment and care and reducing costs for our customers. With our affiliates, we serve more than 1,800 businesses in the area and have offices in Philadelphia, Camp Hill, and Pittsburgh, PA, and Mount Laurel, NJ.
In 1994, CompServices, Inc. began offering workers’ compensation third-party administration services for manufacturers, municipalities, health care facilities, social services, transportation risk, universities, and retail firms. In 1996, AmeriHealth Casualty Insurance Company was established as an extension of our workers’ compensation claims services — its mission to provide workers’ compensation insurance combined with high quality claims service and cost containment.
AmeriHealth Casualty Insurance Company and CompServices write premiums and administer self-insured programs for over 1,800 customers.
Equal Employment Opportunity
AmeriHealth Casualty is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth Casualty employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth Casualty and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth Casualty or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.