Behavioral Health Community Partnership Manager at Elevance Health engaging with behavioral health providers. Driving performance improvement and quality outcomes in behavioral health services across California.
Responsibilities
Establish relationships and engage with BH providers to ensure measurable improvements in clinical and quality outcomes for members.
Build relationships with internal clinical and quality departments to ensure high-quality care to members and achievement of company HEDIS performance.
Implement strategies that meet clinical, quality, and network improvement goals.
Build positive working relationships with providers, state agencies, advocacy groups, and other market stakeholders.
Meet 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, improving provider experience and overall satisfaction with Carelon.
Act 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.
Support regional and corporate initiatives regarding Carelon Select Provider (CSP) program, clinical innovation, and thought leadership transforming provider relationships from transactional interactions to collaboration.
Create and maintain 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.
Partner with network providers and Carelon stakeholders to operationalize innovative programs and online resources to improve clinical and quality outcomes.
Analyze provider reports pertaining to cost, utilization, and outcomes, presenting the data to providers and highlighting trends.
Identify data outliers and opportunities for improvement for individual providers.
Participate in the identification of opportunities for expansion and development of innovative pilot programs, implementation, launch, and efficacy and outcomes measurements.
Requirements
Requires 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, either provider or payer
Current, valid, independent, and unrestricted license such as RN, LCSW, LMFT, LMHC, LPC, or Licensed Psychologist (as allowed by applicable state laws)
Candidates who reside in Shasta, Humboldt, Solano and Sonoma HIGHLY preferred
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