Company :Highmark Health
Job Description :
Are you a behavioral health professional with strong background in evidence-based treatment and program development who is passionate about transforming and innovating behavioral health care at scale? Highmark Health, one of the nation’s largest payor and provider health systems, is recruiting for a Manager of Enterprise Behavioral Health Clinical Quality and Engagement to maintain day-to-day responsibility for clinical design and implementation of key initiatives to advance high-quality, evidence-based care and clinical engagement – with an increasing upstream Behavioral Health focus – across Highmark health plan and provider delivery system (Allegheny Health Network). Working with leadership within the Enterprise Behavioral Health organization and teams across many other departments, this position will support key initiatives to: (1) develop and maintain a high-performance behavioral health network, (2) advance the delivery of evidence-based psychological treatments, (3) support development of Behavioral Health Coaches and low-intensity interventions, (4) develop clinical and educational content for promoting awareness of and more positive attitudes toward mental illness and treatment, and (5) other key initiatives.
Highmark Health is a national, blended health organization that includes one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network with annual revenues of over $20 billion. The enterprise serves more than 6 million members nationwide and employs 35,000 employees.
Remote/virtual work opportunities will be considered.
- Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
- Provide clinical oversight, training, and development of Behavioral Health Coaches, with a focus on evidence-based approaches (e.g., motivational Interviewing, problem-solving) and support the design and implementation of associated workflows, as part of advancing and maximizing the potential of lower-intensity interventions and promoting engagement
- Support the clinical development and maintenance of a high-performance BH network, including development of criteria and processes for clinical evaluation and monitoring of providers, creation of clinical standards, and incentives to drive high-quality care
- Support program planning and implementation designed to promote the delivery of evidence-based psychological treatments within the Center of Excellence in Evidence-Based Psychological Treatments
- Lead the development of education and clinical content development for promoting employee wellness, understanding of behavioral health issues and treatments, and for other programs and purposes. Support integration of BH care into non-traditional care settings. Provide training to and interface with clinical team members and leaders on the ground. Support processes for evaluation, including evaluation of clinical and health outcomes, engagement, and return on investment, and processes for continuous improvement.
- Provide clinical input and support to the development of alternative payment models (e.g., value-based reimbursement, pay-for-performance) designed to advance and sustain the delivery of high-quality, evidence-based care
- Support the development and implementation of programs to promote patient, member, and provider/employee engagement; support clinical content development of programs and innovative approaches for promoting direct-to-consumer outreach and engagement campaigns and anti-stigma messaging and training
- Collaborate closely with key partners across the enterprise including Clinical Services, Product and Health Experience, Clinical Care and Wellness teams, Workforce Management, Quality, Safety, & Value, Project Management, Training, Enterprise Data & Analytics, Reporting, Sales, Marketing, Finance and provider partners, to design new and enhance existing programs. Collaborate extensively with market leaders, product, sales and other key areas to develop and implement solutions for emerging market and client needs including the requirements of CMS.
- Regularly use scientific research, clinical practice guidelines, and other information sources to guide decision-making and program development; engage in literature reviews to inform Behavioral Health leadership and other team members on key clinical issues and questions; identify evidence-based and best practices as well as continuously raise the expectations of performance and remain competitive with the product offerings of other health plans and care management vendors. Develop quality metrics and education initiatives for pilots and strategies that improve and challenge our current delivery model and addresses challenges in hand-offs during transitions of care, safety and appropriate levels of care.
- Other duties as assigned or requested.
- 5 years in Behavioral health clinical, research, or training
- 3 years in Leadership
- Experience with or knowledge of behavioral health coaching or lower-intensity psychological interventions
- Specific knowledge of and experience with evidence-based psychological treatments
- Highly motivated with exceptional organizational skills, including the ability to effectively and competently handle multiple responsibilities simultaneously and the flexibility and ability to quickly adapt to changes in work objectives, promotions, and available technology.
- Exceptional writing skills and content development skills, including ability to communicate and articulate strategic ideas, solutions, and clinical concepts.
- Excellent clinical and training skills, emphasizing skills rooted in evidence-based psychological treatments
- Independently and in a team, be able to identify the root issues and formulate potential solutions and/or goal-oriented action plans in a professional environment.
- Successfully partners through collaboration and sense of urgency regarding process implementation and improvement/optimization.
- Outstanding oral communication and interpersonal skills
- Strong ability to work at all levels within organization
- Strong analytic skills and business acumen
- Impact-focused and results-oriented
- Ability to build and foster strong culture of collaboration and teamwork
- Doctorate in Psychology or Psychiatry OR Master's Degree in Social Work, Nursing, Mental Health Counseling, Marriage/Family Therapy or related field
LICENSES or CERTIFICATIONS
Professional license in area of specialization
Language (Other than English):
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Office- or Remote-based
Teaches / trains others
Travel from the office to various work sites or from site-to-site
Works primarily out-of-the office selling products/services (sales employees)
Physical work site required
Lifting: up to 10 pounds
Lifting: 10 to 25 pounds
Lifting: 25 to 50 pounds
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
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