Anticipated End Date:

2025-02-21

Position Title:

Manager of BH Clinical Quality - CT CCBHC

Job Description:

Position Specific Details: The successful candidate will be responsible for the oversight and submission of all Carelon contract deliverables for the CCBHC project, including provision of advice and consultation on leveraging the resources of the contractor in setting, tracking, and fulfilling project goals and coordinating activities related to metric development, reporting, data submissions, evaluation, clinic certification, TA & Training, and Steering Committee, sub-committee, and workgroup facilitation. 

Location: The hire will be required to be within 50 miles of our company location/Pulse Point in Rocky Hill, CT and may be required to work in office 1-2x a week.

The Manager of BH Clinical Quality - CT CCBHC is responsible for managing the day-to-day activities of one or more behavioral health (BH) clinical quality program components, which may be related to HEDIS reporting, Performance Measurement and Quality Improvement, NCQA accreditation and/or other quality assurance related activities for one or more health plans. The manager is a client facing role, attending joint operating and other committees as required by the health plan(s). 

Primary duties may include, but are not limited to: 

Implements and evaluates current behavioral health processes including operational statistics, service standards and process improvement initiatives. Provides oversight in the planning, implementation and coordination of BH health care audits to ensure high-quality, cost-effective care. Participates in internal and external BH quality review activities. Manages and oversees BH quality assurance activities, which may include, but is not limited to: managing the production, analysis, and submission of the annual HEDIS report; overseeing community health promotion and disease management initiatives in each state in the region; coordinating audit activities with other regions; managing achievement and maintenance of NCQA accreditation; scheduling all information for surveys, conducting mock audits, and providing consultation to business units and team leads as regards NCQA standard issues. Hires, trains, coaches, counsels, and evaluates performance of direct reports. Content supervision of indirect reports.

Position requirements:

Requires BA/BS degree and a minimum of 3 years of managed care experience including experience in program development and knowledge of the quality process and QI techniques as well as a minimum of 2 years leadership experience; or any combination of education and experience which would provide an equivalent background. 

Preferred qualifications, skills, and experience:

MA/MS degree preferred.Excellent communication skills, including strong writing, PowerPoint development, and public speaking.Knowledgeable regarding evidence-based practice, performance improvement, and implementation science methodologies.Familiarity with state and/or federal grants management activities.Strong leadership and negotiation skills.Skilled at client and community engagement.Program lead or related experience with program administration.Adept at setting reasonable, attainable, and measurable goals and objectives consistent with state and project mission and vision while tracking progress toward goal attainment.Prior experience or strong familiarity with the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Certified Community Behavioral Health Clinic (CCBHC) Initiative.  
 

Job Level:

Manager

Workshift:

1st Shift (United States of America)

Job Family:

MED > Healthcare Role (Non-Licensed)

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.