A healthcare company in New York City is looking to add a new Manager of Behavioral Health Quality (RN, LPN, or LMSW/LCSW) to their Behavioral Health Quality Management team. In this role, the Manager of Behavioral Health Quality (RN, LPN, or LMSW/LCSW) will define and strategically develop the organization's Quality Improvement (QI) strategy for Behavioral Health (BH) metrics. ***This is a Hybrid opportunity requiring the qualified professional to work onsite at least 2 days a week*** Responsibilities: The Manager of Behavioral Health Quality (RN, LPN, or LMSW/LCSW) will:
- Develop and implement the organization's Quality Improvement (QI) strategy for Behavioral Health (BH) metrics, leading a cross-functional team to design, execute, and assess QI initiatives and data research to enhance quality performance as defined by NCQA, DOH, CMS, and other regulatory bodies
- Collaborate with BH Care Management, Pharmacy, and other departments to allocate resources effectively to address performance gaps, ensuring a coordinated and measured quality strategy aimed at maximizing performance in the state's Quality Incentive Award (QIA) programs, particularly focusing on the Health and Recovery Plan
- Lead QI Specialists and Clinical Outreach Specialists in the design, implementation, and evaluation of projects aimed at supporting HEDIS/QARR and engaging high-risk members
- Spearhead data analytics efforts to identify improvement areas, understand behaviors, and evaluate BH metrics, while fostering innovative problem-solving among the team
- Collaborate with providers to improve quality performance in BH metrics, develop incentives, and ensure data integrity, while aligning action plans with the organization's QI strategy
- Oversee quality and performance improvement projects, document performance indicators and outcomes, and report to CMS/DOH/IPRO, ensuring compliance with regulatory requirements
- Drive provider education initiatives on behavioral health aspects, participate in quality committees, and develop/deliver intra-department training to support state and plan initiatives
Qualifications:
- Master's degree in a clinical discipline
- Active NYS license as an RN, LPN, or LMSW/LCSW
- 10+ years' experience in the healthcare industry, with a focus on clinical and quality improvement process methodologies
- 5+ years' experience supervising and managing staff
- Familiarity with HEDIS and QARR requirements
- Clinical experience in behavioral health or mental health settings
- Advanced proficiency in Microsoft Office applications, including Word, Excel, PowerPoint, and Access
Desired Skills:
- Six Sigma Yellow or Green Belt
- Project management and documentation skills