Associate Behavioral Health Program Specialist
3 weeks ago
**Location**: Hybrid
**Compensation**: $51,300 - $77,000
**Jump into the new world of health insurance**:
At Blue Cross & Blue Shield of Rhode Island (BCBSRI), our business is healthcare. But our focus is on improving lives. Be part of a team that is large enough to make a difference but small enough to be innovative. Work in a rapidly changing field. Take a chance to be creative. Move outside the status quo. Shape new ideas with the power of a national brand behind you.
**Join others who know diversity is strength**:
**We appreciate and celebrate everything that makes us unique**: age, national origin, citizenship status, perspectives, experiences, physical or mental disability, military status, race, ethnicity, religion, gender, sexual orientation, gender identity and/or expression. Our diversity strengthens us as an organization and helps us better serve an increasingly diverse Rhode Island population.
**Why this job matters**:
Assist in the overall implementation and daily operations of behavioral health (BH), quality, and delivery systems transformation initiatives internally as well as in the community. Track program implementation, metrics, opportunities, and overall visibility of behavioral health initiatives. Contract with behavioral health facilities to ensure a quality focused, high-performing behavioral health network and to ensure network adequacy for BCBSRI members.
**What you will do**:
- Assist in overall management of behavioral health programs that align with an integrated cost-effective delivery model to improve member quality of life.
- Serve as primary behavioral health facility contracting liaison. Maintain contracts with BH facilities to ensure a quality-focused, high performing BH network.
- Manage operational aspects of BH programs. Provide support to internal areas to resolve BH provider claims/payment inquiries. Collaborate with key areas to ensure appropriate system configuration to support BH programs. Collaborate with key areas to resolve BH provider issues. Triage and track operational issues; mobilize stakeholders for effective problem resolution. Attend applicable committees.
- Assist in BH program development and implementation. Identify key stakeholders, develop business requirements and business case, facilitate execution of business requirements, monitor report and analyze program process and outcome metrics.
- Assist with the development and implementation of a provider communication strategy. Collaborate with identified areas to develop and maintain a behavioral health provider web page.
- Prepare documentation, data, and reports for management and quality oversight committees as needed.
- Participate in department projects and initiatives.
- Perform other duties as assigned.
**What you need to succeed**:
- A combination of education and related experience
- One to three years of experience in behavioral health clinical quality activities or applicable experience in the health insurance industry
- Knowledge of clinical quality management principles or business process improvement techniques
- Knowledge of managed benefits strategies, utilization review techniques, health care financing and delivery, and disease management and case management program development
- Knowledge of regulatory and accrediting standards including, but not limited to NCQA, URAC, DOH, DHS, CMS
- Facilitation skills
- Strategic and critical thinking skills
- Strong analytical skills
- Strong business acumen and political savvy
- Strong negotiation skills
- Strong written and verbal communication skills
- Strong problem solving skills
- Ability to work effectively with a wide variety of people in individual and group settings
- Strong organizing skills, with the ability to prioritize and respond to shifting deadlines
- Strong time management skills
- Ability to manage diverse and deadline-oriented workflow
- Ability to work in a fast paced dynamic work environment.
Extras
- Experience with contract development and negotiation
- Project management skills
- Experience in program development, including staff training
**Location**:
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
- In-office: onsite 5 days per week
- Hybrid: onsite 2-4 days per week
- Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
At Blue Cross & Blue Shield of Rhode Island (BCBSRI), diversity and inclusion are central to our core values and strengthen our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity, affirmative action employer. We provide equal opportunities without regard to race, c
-
Behavioral Health Specialist I
2 days ago
Providence, United States Lifespan Health System Full timeUnder the direction of Clinical Nurse Manager (Inpatient)/ Program Director (Partial) and Unit Charge RN, the Behavioral Health Specialist I (BHS I) is responsible for providing care and safety to children and adolescents as a member of the interdisc Behavioral Health, Behavioral, Specialist, Charge RN, Nurse Manager, Program Director, Healthcare
-
Behavioral Specialist
4 weeks ago
Providence, United States Meeting Street Full timeDescription: Looking for a rewarding career that makes a difference in children’s lives? Look no further and join the team at Meeting Street! Meeting Street is a special place of learning, where children of all abilities have the opportunities to reach their fullest potential. Full-time employees receive: - Competitive Pay - $2,500 sign on bonus -...
-
Behavioral Health Specialist
6 days ago
Providence, United States CharterCARE Health Partners Full timeSummary: Develops, coordinates and implements structured and unstructured milieu treatment interventions. Participates in structured and unstructured therapeutic groups, including role of co-therapist in identified groups. Participates as an active member of the health care team in the collaboration of care. Provides education and leadership to peers...
-
Behavior Specialist
2 weeks ago
Providence, United States Rhode Island Department of Education Full timeFSRI is always looking for candidates that want to make a positive impact on the community we serve in! Essential Functions: Work as part of a multidisciplinary team in a private day treatment program for children ages 5-14 with challenging behaviors. Responsibilities include assisting teachers with academic support, working as part of the clinical team in...
-
Behavioral Health Specialist
2 weeks ago
Providence, United States Charter Care Health Partners Full timeSummary: Develops, coordinates and implements structured and unstructured milieu treatment interventions. Participates in structured and unstructured therapeutic groups, including role of co-therapist in identified groups. Participates as an active member of the health care team in the collaboration of care. Provides education and leadership to peers...
-
Program Director
1 month ago
Providence, United States CODAC Behavioral Healthcare (CODAC Inc.) Full timeCODAC believes in saving lives by understanding the whole person. We tailor patient centered, wrap-around care to meet our patients’ needs. CODAC uses evidence based addiction treatment medicine and behavioral healthcare, combined with a compassionate presence. We offer hope for all who struggle with substance use and mental health disorders throughout...
-
Program Director
4 days ago
Providence, United States CODAC Behavioral Healthcare (CODAC Inc.) Full timeCODAC believes in saving lives by understanding the whole person. We tailor patient centered, wrap-around care to meet our patients’ needs. CODAC uses evidence based addiction treatment medicine and behavioral healthcare, combined with a compassionate presence. We offer hope for all who struggle with substance use and mental health disorders throughout...
-
Program Director
1 month ago
Providence, United States CODAC Behavioral Healthcare (CODAC Inc.) Full timeCODAC believes in saving lives by understanding the whole person. We tailor patient centered, wrap-around care to meet our patients’ needs. CODAC uses evidence based addiction treatment medicine and behavioral healthcare, combined with a compassionate presence. We offer hope for all who struggle with substance use and mental health disorders throughout...
-
Housing Case Manager for Providence
6 days ago
Providence, United States Thrive Behavioral Health Full timeJob Details Description Thrive's Housing First team practices a client centered approach to meet individuals where they are. We are a community-based program that follows the Housing First model which is an evidenced-based practice. We work with individuals throughout the state who are currently or have been chronically homeless. We have a culturally...
-
Housing Case Manager for Providence
20 hours ago
Providence, United States Thrive Behavioral Health Full timeJob Details Description Thrive's Housing First team practices a client centered approach to meet individuals where they are. We are a community-based program that follows the Housing First model which is an evidenced-based practice. We work with individuals throughout the state who are currently or have been chronically homeless. We have a culturally...
-
Housing Case Manager for Providence
2 weeks ago
Providence, United States Thrive Behavioral Health Full timeJob Details Description Thrive's Housing First team practices a client centered approach to meet individuals where they are. We are a community-based program that follows the Housing First model which is an evidenced-based practice. We work with individuals throughout the state who are currently or have been chronically homeless. We have a culturally...
-
Providence, United States Providence Community Health Centers Full timeNew Opportunity - Triage Integrated Behavioral Health Clinician - LICSW, LMHC The Triage Integrated Behavioral Health Clinician provides coverage and crisis triage across all primary care teams at PCHC. The clinician works directly with the call center, front desk staff, integrated care team and medical care teams as the first point of contact when a...
-
School Psychologist Specialist
2 weeks ago
Providence, United States Rhode Island Department of Education Full timeJOB DESCRIPTION Providence Public Schools District (PPSD) seeks an exceptional SCHOOL PSYCHOLOGY SPECIALIST who is highly qualified and skillful to join our community of teachers, students and stakeholders. This is an exciting opportunity for teachers who seek a challenging yet rewarding teaching experience. The School Psychologist Specialist is a member of...
-
Integrated Behavioral Health Clinician
1 month ago
Providence, United States The Providence Community Health Centers, Inc. Full timeJob DescriptionJob DescriptionHIRING AT PROVIDENCE COMMUNITY HEALTH CENTERS:INTEGRATED BEHAVIORAL HEALTH CLINICIAN(LICSW, LCSW or LMHC)Are you LICSW, LCSW or LMHC looking to expand your skills by working in primary care?Do you enjoy working with children, adolescents and adults in a clinical model that is short-term, evidence-based and fast-paced?Do you want...
-
Triage Integrated Behavioral Health Clinician
4 weeks ago
Providence, United States The Providence Community Health Centers, Inc. Full timeJob DescriptionJob DescriptionNew Opportunity - Triage Integrated Behavioral Health Clinician - LICSW, LMHCThe Triage Integrated Behavioral Health Clinician provides coverage and crisis triage acrossall primary care teams at PCHC. The clinician works directly with the call center, front deskstaff, integrated care team and medical care teams as the first...
-
Community Health Worker RIDOH Grant
1 day ago
Providence, United States Thrive Behavioral Health Full timeJob Details Job Location Providence, RI Description GENERAL SUMMARY: The WWHEZ Community Health Worker (CHW) is a peer who has experience in navigating Rhode Island's health system for themselves, a family member or through previous employment. This CHW will work with the Housing First Program, addressing the Social Determinants of Health for individuals...
-
LCSW/LPCC Behavioral Health Provider
1 month ago
Providence, United States Regional Health Care Affiliates, Inc Full timeJob DescriptionJob DescriptionDescription:· Formulate, implement and evaluate an outcome based treatment plan for each client.· Conduct individual, family or group psychotherapy using all generally accepted methods for brief or long term therapy.· Refer mental health patients for home health services, as appropriate.· Prescribe, monitor, administer,...
-
Behavioral Health Specialist
2 weeks ago
Providence, United States St Joseph School Of Nursing Full timeSummary: Develops, coordinates and implements structured and unstructured milieu treatment interventions. Participates in structured and unstructured therapeutic groups, including role of co-therapist in identified groups. Participates as an active member of the health care team in the collaboration of care. Provides education and leadership to peers...
-
Behavior Specialist, Mount Pleasant Academy
7 days ago
Providence, United States The City of Providence Full timeFSRI is always looking for candidates that want to make a positive impact on the community we serve in!Position Summary: Work as part of a multidisciplinary treatment team in a day program for children with mental health needs. Some duties include educational/behavioral data collection as required; Behavior management, crisis intervention with and on behalf...
-
Psychiatrist Physician
1 day ago
Providence, Rhode Island, United States CharterCare Health Partners Full timeCharterCARE Health Partners (CharterCARE) is a community-based healthcare system anchored by two acute care hospitals. Roger Williams Medical Center is a leading research and teaching hospital that hosts a nationally recognized cancer center. Our Lady of Fatima Hospital is a high-quality community hospital that hosts one of New England s best rehabilitation...