Working closely with the Behavioral Health clinical leadership team, the BH Operations Manager will identify, gather and analyze various data points to ensure optimal program functioning. This position will monitor the day-to-day functioning of the BH clinical teams, with a special focus on HARP, and will support leadership to evaluate the effectiveness of the behavioral health policies, procedures and workflows. He/She will interface with internal stakeholders and external partners, such as BH Providers, Health Homes and Home and Community Based Providers to assist the BH Clinical teams in achieving program goals and improved patient outcomes.
- Monitoring of program operations to ensure optimal functioning in key areas including: utilization of services; coordination of care between BH teams, general medical teams, and external partners; progress toward identified program outcomes, and; adherence to regulatory guidelines.
- Compile, interpret and present data to BH HARP QI and UM Committee meetings.
- Serve as primary liaison for Home and Community Based Providers and represents on external committees in order to ensure consistent, high quality service delivery and effective implementation of HARP program model.
- Work collaboratively with BH Network teams and clinical teams to implement identified solutions to barriers in care coordination and service delivery such as: communication; access to care; coordination of service delivery; and member engagement.
- Utilizes the most current data available to provide prospective, concurrent and retrospective analysis of program effectiveness and support the improvement of Behavioral Health operations and programming
- Create and implement policies, procedures and workflows designed to improve BH operations.
- Maintains knowledge of regulatory and contractual guidelines to ensure program compliance.
- Focuses on the improvement of operations including: policies, procedures and workflows; care management practices; benefit configuration and; claims monitoring.
- Performs other duties as assigned
- Bachelors degree in healthcare related field or equivalent experience
- Minimum 2 years experience within the BH Services setting in NYC
- Masters degree in healthcare related field
- Knowledge of NYS Medicaid Program
- Experience working with high performing, cross functional teams
- Sound organizational skills with the ability to handle multiple tasks and prioritize appropriately
- Ability to analyze data, recognize trends and make recommendations for action as appropriate
- Flexible, adaptable, and excellent problem solving skills
- Results-oriented, Self-directed
- Demonstrated effectiveness with written and oral communications
- Outstanding interpersonal skills
Compliance & Regulatory Responsibilities: N/A
Please note: Since we care so greatly about our employees and members wellbeing, Healthfirst is moving to a fully vaccinated in-office environment. You must be vaccinated to work in our offices, even if you are partially remote. If you are selected to interview for this role, we will explain our vaccination policy and ensure you are comfortable moving forward with further interviews based on your work location.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.