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Elevance Health
Indianapolis, IN, United States
Anticipated End Date: 2024-07-08 Position Title: Behavioral Health Provider Quality Manager Job Description: Location: The ideal candidate must live within 50 miles of the Indianapolis, IN Elevance Health Pulse Point location. Shift: Monday - Friday; 8am - 5pm The Behavioral Health Provider Quality Manager is responsible for leading Beha
Job Source: Elevance HealthFedEx Logistics
Mooresville
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Job Source: FedEx LogisticsFedEx Logistics
Plainfield
**AboutFedEx Supply Chain** FedExSupply Chain, a subsidiary of FedEx Corp. (NYSE: FDX), is a leader in thethird-party logistics industry offering a diverse service portfolio thatenables commerce for businesses. With a proven track record of innovation andoperational excellence, FedEx Supply Chain takes a consultative approach tooptimize logistics p
Job Source: FedEx LogisticsAllison Transmission
Indianapolis
JOIN THE TEAM THAT’S POWERING PROGRESS Building cities. Driving commerce. Saving lives. For over 100 years, Allison Transmission has powered the vehicles and technology that move our world forward.What powers us? Our employees. From the first person hired by James Allison in 1915 to the thousands across the globe who work for Allison today, we’re d
Job Source: Allison TransmissionDamar Services
Indianapolis, IN, United States
At Damar, our people are remarkable! Our staff are dedicated to serving our clients to achieve remarkable results. We are a diverse team of people with a wide range of skills and experiences interested in careers that matter. We provide a place where you can fulfill your career ambitions. With competitive benefits, a culture of compassion, belongin
Job Source: Damar ServicesDamar Services
Indianapolis, IN, United States
: At Damar, our people are remarkable! Our staff are dedicated to serving our clients to achieve remarkable results. We are a diverse team of people with a wide range of skills and experiences interested in careers that matter. We provide a place where you can fulfill your career ambitions. With competitive benefits, a culture of compassion, belong
Job Source: Damar ServicesAcadia Healthcare
Indianapolis, IN, United States
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Job Source: Acadia HealthcareAdvanced Recovery Systems LLC
Indianapolis, IN, United States
Overview: We are looking to add Behavioral Health Technicians at our Indianapolis, IN Facility! All shifts (Full Time, Part Time/PRN) Advanced Recovery Systems is an integrated behavioral healthcare management company dedicated to the treatment of addiction, substance abuse, and mental health issues. We put behavioral health front and center, prov
Job Source: Advanced Recovery Systems LLCIndianapolis
**Location:** The ideal candidate must live within 50 miles of the **Indianapolis, IN** Elevance Health Pulse Point location.
**Shift:** Monday – Friday; 8am – 5pm
The **Behavioral Health Provider Quality Manager** is responsible for leading Behavioral Health (BH) provider engagement, with a focus on leveraging the data available to providers and helping to improve the value delivered to Carelon members. Drives BH provider performance improvement year over year through education and data. This role is responsible for a local market.
**How you will make an impact:**
+ Establishes relationships and engages with BH providers and ensures measurable improvements in clinical and quality outcomes for members.
+ Builds relationships with internal clinical and quality departments to ensure high quality care to members and achievement of company HEDIS performance.
+ Implements strategies that meet clinical, quality, and network improvement goals through positive working relationships with providers, state agencies, advocacy groups and other market stakeholders.
+ Meets with providers face to face, telephonically and via Web-Ex.
+ Acts as a liaison between strategic providers and Carelon clinical, quality, provider strategy, network departments, operations, claims, and provider relations to ensure interdepartmental collaboration and coordination of goals and priorities and to support linkages for issue resolution, helping to improve provider experience and overall satisfaction with Carelon.
+ Supports regional and corporate initiatives regarding Alternative Payment Models (APM), including Value Based Payment (VBP), clinical innovation, and thought leadership transforming provider relationships from transactional interactions to collaborative aggregate data assessment.
+ Creates and maintains linkages between providers of all levels of care, as well as other community-based services and resources to improve transitions of care and continuity of services.
+ Partners with network providers and Carelon stakeholders to operationalize innovative programs and strategies to improve clinical and quality outcomes.
+ Analyzes provider reports pertaining to cost, utilization, and outcomes, and presents the data to providers and highlights trends.
+ Identifies data outliers and opportunities for improvement for individual providers.
+ Identifies high-performing and innovative providers who may be interested in new programmatic or payment models.
+ Collaborates with regional leadership and network teams to identify providers who are best suited for APMs, preferred provider networks, and/or other aggregate data management programs. Participates in the identification of opportunities for expansion and development of innovative pilot programs, to include program development, implementation, launch, and efficacy and outcomes measurements.
+ Contributes to the identification of best practices and integrates high-quality program ideas/designs into the local market to drive high levels of value.
+ Provides consultation to providers for clinically complex members as applicable.
+ Surfaces clinical and quality issues to regional clinical and quality teams and participates in helping to address concerns.
+ Conducts medical record reviews annually or as needed with network providers across all service levels.
+ Assists with provider orientations and provider training events in the region, when applicable.
**Minimum Requirements:**
+ Requires MA/MS or above in Behavioral Health field and minimum of 10 years of progressively responsible professional experience in healthcare which includes a minimum of 5 years’ experience in a behavioral health setting, either provider or payer; or any combination of education and experience, which would provide an equivalent background.
+ Current, valid, independent, and unrestricted license such as RN, LCSW, LMFT, LMHC, LPC, or Licensed Psychologist (as allowed by applicable by state laws) is required.
**Preferred skills, capabilities, and experiences:**
+ Managed care experience preferred.
+ Travels to worksite and other locations, as necessary.
Email Alert for Behavioral Health Provider Quality Manager_ jobs in Indianapolis
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