Quality Management Behavoiral Health Provider Liasion
3 weeks ago
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + HospitalsMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview
The Quality Management Behavioral Health Provider Liaison (BHPL) serves as the primary partner for Behavioral Health providers to improve performance in key HEDIS/QARR metrics. The BHPL is a strategically oriented professional who helps lead provider engagement, with a focus on leveraging data available to providers, and improve the value delivered to MetroPlusHealth members. The BHPL achieves this by building highly collaborative and strategic partnerships and bringing an analytic mindset to discussion with providers. The successful candidate will build relationships with internal teams, coordinate with clinical and quality departments, and achieve HEDIS/QARR performance. The BHPL drives provider performance improvement year-over-year through education, establishment of best practices, use data driven interventions and ensure data integrity/completeness. The BHPL will train practices how to utilize available tools to improve care for members with Behavioral Health conditions, implement population health strategies, understand how their practice is performing on Key Performance Indicators and other health outcome measures, and properly code/document for HEDIS/QARR events.
Job Description- Partner with contracted inpatient/outpatient Mental Health and Rehab/Detox facilities to provide support to Behavioral Health Providers through face-to-face, virtual and telephonic meetings. These strategic partnerships will be designed to increase provider knowledge of behavioral health HEDIS/QARR measures, provide supporting performance data and goals, and establish linkages between inpatient and outpatient behavioral health providers.
- Communicate provider data needs back to the organization to ensure end-to-end partnership.
- Review present state provider coding/documentation practices and educate on proper claims submission protocols.
- Create new data streams to ensure high data integrity/completeness for HEDIS/QARR submissions.
- Educate providers on medication and treatment compliance and promote the use of Long Acting Injectables and Medication Assisted Treatment.
- Communicate complex data in a way that is easy to understand.
- Partner with network providers to assess current state and operationalize innovative programs and strategies to improve clinical and quality outcomes.
- Lead the development of root cause analysis, interventions, project planning, tracking and outcome summary reports for specific behavioral health measures.
- Monitor and analyze interventions to ensure goals, objectives, outcomes are met.
- Monitor for adverse measure trends, recommend modifications and corrective actions.
- Develop data collection mechanisms to track performance.
- Conduct initial measure research and quality intervention development for new NCQA/state BH measures.
- Assist in ad-hoc projects that serve to educate and build provider awareness of behavioral health aspects of care including, but not limited to, outreach to increase screenings and referrals by PCPs, build awareness around CORE and BH HCBS services and other state and plan initiatives that require provider education.
- Contribute to the identification of best practices across the entire group of PQMs nationally and integrate high-quality program ideas/designs into the local market to drive high levels of value.
- Ability to travel within local New York City market on a regular basis to meet with high volume providers/provider groups.
- Organize data and create presentations that are effective in assisting providers with performance improvement.
- Develop methods and/or tools to collect and track barriers for targeted members and providers.
- Develop/deliver member and provider communications that are clear, direct, and actionable.
- Consistently applies PDSA methodology to all quality improvement work.
- Responsible for keeping professional license current
- Bachelor’s degree in a clinical field required. Advanced degree preferred.
- Must have a minimum of 5 years’ experience in the health care field, preferably with a managed care organization.
- Previous experience in a large inpatient behavioral health setting.
- Demonstrated ability to communicate effectively, problem solve and work effectively with people.
- Working knowledge of Medical/Behavioral Health terminology including diagnosis, medications, and levels of care. Working knowledge of HEDIS/QARR.
- Must be proficient in Microsoft Word, PowerPoint, Excel and Access.
- Experience with and proficient in data analysis. Working knowledge of relational database and statistical analyses is a plus.
- Must have in-depth knowledge of PDSA methodology and its application and is familiar with and have a working knowledge with QI process improvement methodology strategies including but not limited to DMAIC.
- Must be confident, autonomous, solution driven, proactive and detail oriented. Must possess high standards of excellence, diplomacy, resourcefulness, and strong intuition.
- High quality of interpersonal/team skills.
- Understanding of patient confidentiality.
- Ability to work in a fast-paced environment.
- Excellent time management and organizational skills.
- Ability to prioritize and manage changing priorities under pressure
- Current licensed RN (Psych preferred), LPN, LMHC, or LMSW/LCSW
- Six Sigma Yellow or Green Belt preferred.
Professional Competencies
- Integrity and Trust
- Customer Focus
- Functional/Technical/Analytical Skills
- Teamwork
- Written/Oral Communications
#LI-Hybrid
-
New York, United States MetroPlusHealth Full timeJob DescriptionJob DescriptionEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health +...
-
New York, New York, United States MetroPlus Health Plan Full timeJob OverviewThe Quality Management Behavioral Health Provider Liaison (BHPL) serves as a key partner for Behavioral Health providers to improve performance in key HEDIS/QARR metrics. This role is responsible for building highly collaborative and strategic partnerships with providers to leverage data and improve the value delivered to MetroPlusHealth...
-
Director of Quality Management- Gotham Health
6 months ago
New York, United States NYC Health + Hospitals Full timeAbout NYC Health + HospitalsNYC Health + Hospitals/Gotham Health is one of the largest Federally Qualified Health Center (FQHC) in the country, providing coordinated world-class primary and specialty care with dignity and respect for all New Yorkers, without exception. At Gotham Health, we practice a person-centered caring culture that values delivering...
-
New York, New York, United States Provider Healthcare Full timeWe are seeking an experienced Dentist to join our team at Provider Healthcare in Jamestown, NY. As a key member of our healthcare team, you will play a vital role in delivering high-quality patient care and ensuring the well-being of our community.About the JobThis is a rewarding opportunity to work as a primary care dentist, diagnosing and treating patients...
-
Director of Quality Management- Gotham Health
2 months ago
new york city, United States NYC Health + Hospitals Full timeAbout NYC Health + HospitalsNYC Health + Hospitals/Gotham Health is one of the largest Federally Qualified Health Center (FQHC) in the country, providing coordinated world-class primary and specialty care with dignity and respect for all New Yorkers, without exception. At Gotham Health, we practice a person-centered caring culture that values delivering...
-
Quality Manager
1 week ago
New York, United States Disability Solutions Full timeOverview*** This position is contingent upon contract award ***SOSi is seeking a highly qualified Quality Manager to join our team supporting Health Services operations in Batavia, NY.Essential Job DutiesDevelop, implement and oversee quality plan to support delivery of the highest quality patient care, optimal patient flow, provider productivity and...
-
VP of Quality Management
1 week ago
New York, United States MetroPlus Full timeEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest...
-
VP of Quality Management
1 week ago
New York, United States MetroPlusHealth Full timeJob DescriptionJob DescriptionEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health +...
-
VP of Quality Management
2 weeks ago
New York, United States MetroPlusHealth Full timeJob DescriptionJob DescriptionEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health +...
-
Healthcare Quality Care Manager
3 weeks ago
New York, New York, United States NYC Health Hospitals Full timeCompany OverviewNYC Health Hospitals is a leading healthcare facility with a rich legacy of providing high-quality care to patients. With over 625 beds and state-of-the-art equipment, our hospital remains on the cutting edge of technology and medicine.We are committed to delivering exceptional patient care and improving health outcomes through innovative...
-
New York, United States NYC Health + Hospitals Full timeAbout NYC Health + HospitalsNYC Health + Hospitals is the largest public health care system in the nation. We are a network of 11 hospitals, trauma centers, neighborhood health centers, nursing homes, post-acute care centers, and correctional health services. We are a home care agency and a health plan, MetroPlus. Our health system provides essential...
-
Quality Management Coordinator
1 week ago
New York, United States Metropolitan Jewish Health System Full timeDo you have a ‘Hospice Heart‘?If your answer is yes, then you are just the nurse we are looking for. When days cannot be added to a life, we add life to remaining days. Our multidisciplinary teams offer culturally-sensitive, end-of-life and palliative care services to patients and their families at home or in assisted living communities, skilled nursing...
-
Women's Health Nurse Practitioner Lead
7 days ago
New York, New York, United States Provider Healthcare Full timeJob SummaryWe are seeking an exceptional Women's Health Nurse Practitioner to join our team in providing high-quality care to patients in an outpatient setting. As a skilled professional, you will be responsible for assessing, diagnosing, and treating women's health cases, referring patients to other providers when necessary, and maintaining accurate medical...
-
Quality Management Specialist
5 days ago
New York, New York, United States Disability Solutions Full timeOverviewDisability Solutions is seeking a highly qualified Quality Manager to support Health Services operations in Batavia, NY. As a key member of our team, you will be responsible for developing and implementing quality plans to ensure the highest level of patient care.Job SummaryWe are looking for an experienced professional with a strong background in...
-
Compassionate Mental Health Care Provider
3 weeks ago
New York, New York, United States Essen Health Care Full timeJob OpportunityEssen Health Care is a leading community healthcare network dedicated to providing high-quality, patient-centered medical care to vulnerable and under-served residents of New York State.We are seeking a skilled Psychiatric Nurse Practitioner to join our Division of Behavioral Health. As a key member of our team, you will be responsible for...
-
Advanced Health Care Provider
1 week ago
New York, New York, United States NYC Health + Hospitals Full timeJob OverviewWe are seeking an experienced Advanced Health Care Provider to join our team at NYC Health + Hospitals/Jacobi. As a licensed independent practitioner, you will be responsible for planning, coordinating, delivering, and managing comprehensive health care services in a fast-paced healthcare setting.About the RoleThis is a full-time position that...
-
New York, United States City of New York Full timeEstablished in , the New York City Department of Health and Mental Hygiene (the NYC Health Department) is the oldest and largest health department in the country. Our mission is to protect and improve the health of all New Yorkers, in service of a vision of a city in which all New Yorkers can realize their full health potential, regardless of who they are,...
-
Director of Quality Management Analytics
1 week ago
New York, United States MetroPlusHealth Full timeJob DescriptionJob DescriptionEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health +...
-
Director of Quality Management Analytics
2 weeks ago
New York, United States MetroPlusHealth Full timeJob DescriptionJob DescriptionEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health +...
-
Family Health Care Provider
3 weeks ago
New York, New York, United States The Institute for Family Health Full timeAbout The Institute for Family HealthThe Institute for Family Health is a leading healthcare organization dedicated to providing high-quality medical services to individuals and families.
