Behavioral Health Resume Samples

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Guide the recruiter to the conclusion that you are the best candidate for the behavioral health job. It’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired.

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A Schinner

Ashleigh

Schinner

82052 Fadel Path

Chicago

+1 (555) 736 4072

82052 Fadel Path

Chicago

Phone

p +1 (555) 736 4072

Experience Experience

Chicago, IL

Behavioral Health Tech

Chicago, IL

Feeney and Sons

Chicago, IL

Behavioral Health Tech

Provides or assists with providing direct patient care, diagnostic procedures and therapeutic interventions
Assists patients with performing activities of daily living
Assists with Electroconvulsive Therapy (ECT) preparation and provides care as designated by the Registered Nurse pre-op and post-op
Recommends quality and/or process improvement initiatives in order to more effectively and efficiently perform the functions of this job
Provides therapeutically effective relationships with assigned patients incorporating developmental and age-related factors
Performs ongoing observation of patient's response to illness and treatment which in turn promotes optimal patient outcome
Serves as a role model for other staff and may assist in orientation/training of new staff

Philadelphia, PA

Behavioral Health Clinician

Philadelphia, PA

Emmerich, Senger and Weber

Philadelphia, PA

Behavioral Health Clinician

Collaborate with primary social worker/case manager/other health care professionals involved in the patient's care
Actively participates in performance improvement activities
Participates in Continuous Quality Improvement Principles: promotes the integration of Continuous Quality Improvement Principles in service delivery
Assists in verifying insurance coverage for patients and provides clinical updates to insurance companies
Provides and coordinates a continuum of treatment services onsite and/or in the community
Provide consultation to the team regarding diagnostic impressions, recommendations, and strategies to engage patients in health and behavior change
Assists in educating patients/families

present

Philadelphia, PA

Behavioral Health Navigator

Philadelphia, PA

Feest Group

present

Philadelphia, PA

Behavioral Health Navigator

present

Establishes and maintains effective working relationships
Supports others in the department and provides help and assistance when possible
Serve as a liaison with other service providers or community supports for the continuous improvement of services to patients
Perform analysis and report of various metrics as requested
Provides culturally competent care
Educate PCP's and clinical staff on alternative care management options
Identify potential legal or risk management issues and discuss with their supervisor

Education Education

Master’s Degree in Behavioral Health

West Virginia University

Master’s Degree in Behavioral Health

Skills Skills

Knowledge of basic medical and psychiatric terminology
Proficient at Microsoft Office products and learning reporting applications
Good organizational skills
Exceptional knowledge of Behavioral Healthcare policies and procedures
Knowledge of nursing practice and exceptional leadership skills
Excellent communication skills
Demonstrated ability in handling day to day operations for a nursing division
Ability to analyze information and formulate effective plans for using information. Sound judgment sufficient to ensure the integrity of operations. Considerable skill in facilitating problem solving
Demonstrated knowledge of contracting process, Behavioral Health provider relations, Medicaid fee schedules, financial terms, and metrics
Good time management skills and self directed

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15 Behavioral Health resume templates

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Clinical Auditor Behavioral Health Resume Examples & Samples

Complete required clinical chart and phone audit of clinical and non-clinical staff, as indicated by policy providing Integrated Medical Behavioral Health Care
Develop performance improvement suggestions on audits performing below established standard
Provide feedback on ways to improve the audit process
Learn and participate in various aspects of the regulatory process of UM in both NCQA and URAC accreditation
Progressive experience working in a behavioral health or related field
Experience with behavioral change
Auditing and accreditation experience

Behavioral Health Medical Director Resume Examples & Samples

Board Certified Psychiatrist
MD/DO with active unrestricted license and the willingness to obtain additional licenses as requested
Excellent communication skills, with 5 years of established behavioral health clinical experience
Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products
Possess analysis and interpretation skills with prior experience leading teams focusing on quality management, utilization management, and discharge planning
Medical management experience, working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc
Previous Medicare, Medicaid, and/or Commercial utilization review experience

Lcsw Behavioral Health Resume Examples & Samples

Current Clinical Social Worker License in state of New York required
3+ years pf experience in a health facility, specifically working with families
Bilingual Spanish or French highly preferred

Behavioral Health Business Informatics Leader Resume Examples & Samples

Deep understanding of strategic planning, direct response marketing, customer loyalty and retention programs, and primary and secondary research processes
Strong database software proficiency
Ability to mentor and manage associates in customer loyalty and direct response methodologies

Director of Behavioral Health Resume Examples & Samples

3+ years of experience in Field and Supervisory experience
Graduate of an accredited School of Nursing, BSN and Master’s Degree in Advanced Clinical Practice Nursing or Graduate of post Master’s certificate program for Nurse Practitioner (NP)
Certification as an Advanced Nurse Practitioner (ANP) in specialty area of Psychiatry
Experience with Care Management software tools

Analytics Consultant, Behavioral Health Resume Examples & Samples

Master’s degree or equivalent in Public Health, Epidemiology, Experimental Psychology, Statistics, Biostatistics, Biomedical Sciences, Biology, Actuarial Science, Computer Science, Mathematics, Engineering, , or related fields
Strong Public Health Background
Experience working with complex and very large datasets
Excellent Excel skills, including pivot tables and other advanced aspects
Ability to present technical, analytical and/or clinical information to a wide variety of audiences

Behavioral Health Care Management Lead Resume Examples & Samples

Responsibilities: * Supervises the BH work unit and personnel, which includes: assuring compliance with HIPAA Privacy and Security policies; providing and/or recommending training; coordinating, scheduling and assigning work product; establishing performance measures, goals, objectives and priorities; evaluating work performance; providing feedback, direction and guidance; keeping personnel abreast of new or revised information; answering questions; and recommending and/or implementing personnel actions. Prioritizes and assigns tasks and projects to staff; tracks and reviews work progress
Excellent verbal, written and interpersonal communication skills are essential
Evidence of ability to work cooperatively, tactfully and assertively with medical providers and others
Proficient in basic computer skills including Microsoft Office programs (Word, Outlook, Excel) along with the ability to access the internet to do research
Proficient in intermediate computer skills including Microsoft Office

Humana Behavioral Health Business Analyst Resume Examples & Samples

Collaborating with business and IT partners to translate business needs to IT requirements and testing plans
Lead teams in the development of high-quality solutions that reach measurable metrics
Create detailed IT requirement documents and task-level testing plans to support cross-functional teams in system and reporting optimization
Partner closely with other members of functional project teams, IT and reporting partners to define business requirements
Facilitate the development of comprehensive projects and rollout plans and procedures
Initiate and facilitate meetings with leaders and subject matter experts within Humana, Humana Behavioral Health and other key partners and IT to identify and document business requirements
Analyze, develop and track key metrics, performance indicators, trends and comprehensive data to improve processes and/or to develop applications to resolve underlying issues
Develop agendas, reporting mechanisms and testing plans for business optimization
Assist in the development and execution of departmental strategic plans and objectives
Build effective relationships with all business partners and stakeholders
Bachelor’s degree in business management, Information Systems or related field or work equivalent (minimum of 10 years’ experience)
Exceptional verbal and written communication skills, exceptional emotional intelligence and strong presentation skills
Demonstrated analytical competencies
Demonstrated experience utilizing Microsoft Excel, Access, PowerPoint
Ability to work effectively within a collaborative environment
Embraces Continuous Process Improvement
Ability to lead in a high profile, fast paced environment
Experience with AGILE teams
PMP or Six Sigma Certification
Experience with Microsoft SharePoint and or SharePoint Designer
EDI Experience

Behavioral Health Resume Examples & Samples

Advanced Practice Registered Nurse or Nurse Practitioner license
1-3 years of Inpatient Psychiatric experience
Exceptional knowledge of Behavioral Healthcare policies and procedures

Humana Behavioral Health Resume Examples & Samples

Negotiate and re-negotiate high-volume, transactional-style physician and ancillary contracts
Create trend analyses and summaries for decision-making purposes
Bachelor’s Degree in Business, Finance or a related field or a minimum of 2 years’ relevant provider contracting experience
Experience presenting to varied audiences
Ability to manage multiple priorities in a fast-paced environment
Driver’s license and vehicle are required
Master’s Degree in Business Administration or a related field Experience with ACO/Risk Contracting

Director, Behavioral Health Services Resume Examples & Samples

Leading and contributing to the development and implementation of company-wide initiatives via consultation, and training programs addressing topics that include but are not limited to behavioral health/health and wellness programs that include leadership skills, diversity appreciation, and assurance of safe and respectful workplaces
Proven experience applying behavioral health clinical assessment and intervention skills to larger systems: work groups, business organizations, and community systems
At least 3 years experience leading multidisciplinary and project teams in a corporate setting
Advanced degree in Behavioral Sciences, with at least 10 years clinical experience
5 or more years employer-based BHS/EAP experience
Proven ability to help human resources and management professionals constructively address organizational matters involving leadership skills, managing change, stress, conflict, and post-trauma situations
Proven ability to drive initiatives that promote healthy behavior as the platform for healthy employees and healthy high performing work groups
Exemplary writing skills and speaking skills with experience in creating and facilitating BHS workshop sessions
Strong analytical abilities in thinking and acting strategically when assessing current and future priorities of the H&W organization
Proven ability to engage respectfully, collaboratively, and effectively with all levels of employees: entry-level employees through senior-level executives
Proven ability to constructively manage conflict and solve problems
Negotiating and influencing skills that include the ability to articulate and stand by ones convictions without alienating others
Proven ability to develop and sustain professional relationships internally and externally with key stakeholders
Demonstrated ability to manage and/or participate on strategic project teams across organizations internally as well as externally
Proficient at computer-based communication and data applications (examples: Lotus Notes, Microsoft Office, Medcomp)
Periodic travel ~ 10% a year
A relevant behavioral health license and certifications, e.g., LCSW, LP, LPC, CEAP, LADC, CADC. Human Resources designations (GPHR, SPHR, PHR) a plus

Behavioral Health Clinical Appeals Frontline Leader Resume Examples & Samples

Serve as a liaison with assigned departments in areas of reporting, quality results and feedback
Promote data integrity and reporting timeliness
Provide appropriate supporting evidence of assigned standards for all organizational accreditation reviews
Identify and implement new strategies to enhance department efficiency and productivity
Coordinate assigned task forces including agenda preparation, meeting facilitation, and minutes preparation
Any other activities as assigned by Clinical Management
Experience in supervising staff or teams
Proficient knowledge of MS Word and Excel
Experience with CGX
Extensive experience with processing appeals, preferably in behavioral health
Experience in utilization management, preferably in behavioral health
Licensure as behavioral health clinician or registered nurse with behavioral health experience
Project coordination or management experience

Behavioral Health Associate Resume Examples & Samples

1 year of psychiatric, client observation, or therapeutic experience
Training on use of restraints and seclusion
Strong therapeutic skills and knowledge
Excellent communication skills and knowledge

Humana Behavioral Health Director of Provider Contracting Resume Examples & Samples

Bachelor’s Degree in Business, Finance or a related field; or a minimum of 7 years’ provider contracting experience with large facilities and complex groups
Solid leadership/management experience including supervisory and teambuilding
Incredible attention to detail
Experience working in a matrixed organization
Familiarity with contracting public relations
Master’s Degree in Business Administration or Finance JD Degree
Tricare contracting expertise

VP, Behavioral Health Services Resume Examples & Samples

Developing and leading implementation of company-wide initiatives and training programs, including, but not limited to behavioral health, leadership skills, employee assistance, and work/life effectiveness
Consulting with, training, and assisting business leaders on managing difficult workplace situations
Collaborating within Health and Wellness leadership team to develop marketing strategies and materials for BHS/ EAP and related programs
Analyzing data from multiple sources to identify risks as well as current clinical conditions; and developing programs to improve the work environment and current health trends
Implementing processes directly aligned with Health and Wellness behaviorally-focused initiatives, including Workplace Violence Incident Oversight Team
Representing Prudential Health and Wellness at professional meetings internally and externally
Collaborating with external partners to develop community-focused health and wellness initiatives
Working within Health and Wellness leadership team to develop programs and services for Prudentials international businesses
At least 5 years program leadership experience in a corporate setting
Advanced degree in Behavioral Sciences, with at least ten years clinical experience
Five or more years internal BHS/EAP experience
Proven experience applying behavioral health clinical skills to larger systems: work groups, business organizations, and community systems
Proven ability to lead initiatives that help human resources and management professionals constructively address organizational matters involving change, stress, conflict, and post-trauma
Proven ability to lead initiatives that promote healthy behavior as the platform for healthy employees and healthy, high performing work groups
Exemplary writing skills and speaking skills
Proven commitment to diversity affirmation, demonstrated by leadership of relevant projects/initiatives
Strong analytical abilities, demonstrated by the ability to think and act strategically
Proven ability to develop and sustain professional relationships
Demonstrated ability to lead strategic project teams
Prior experience managing staff, consultants, and/or vendors
Periodic travel
Relevant behavioral health licenses and certifications, e.g., LCSW, LPC, CEAP, LADC, CADC. Human Resources designations (GPHR, SPHR, PHR) a plus

Administrative Director of Behavioral Health Resume Examples & Samples

6+ years experience in a Managerial capacity in the Behavioral Health area
Master's Degree in a Behavioral Health field; Advanced Degree or completion of significant coursework specific to Health Care Management / Business Administration
CT Licensed Social Worker (LSW), Licensed Clinical Social Worker (LCSW), Registered Nurse (RN), and/or Nurse Practitioner (NP) license
Familiar with managed care, contracting, data warehouse reporting, reimbursement trends, regulatory requirements (JCAHO, State, Medicare), and business plan modeling

Behavioral Health Medical Director Resume Examples & Samples

Board Certified MD/DO in a ABMS Medical Specialty with an active unrestricted license and the willingness to obtain additional licenses as requested
Excellent communication skills with 5 years of established clinical experience
Possess analysis and interpretation skills with prior experience leading teams focusing on quality management, utilization management, discharge planning and/or home health or rehab
Internal Medicine, Family Practice, Geriatrics, Hospitalist clinical specialists
Previous Medicare, Medicaid, and/or Commercial experience

Humana Behavioral Health Resume Examples & Samples

The point of contact for any communication documents required by between HGB as outlined within the statement of work
The point of contact for any presentations required by HGB or HBH to illustrate the clinical outcomes and performance of the Humana Military team, comprised of HBH and HGB
Point of contact for internal and external communication needs to beneficiaries, providers, associates
Serving as a liaison between the Humana Military HBH team, HGB communications, other HBH departments, and corporate
Serving as a liaison, you will be responsible for ensuring presentations and technical written documents, or other issues needing resolution get to the appropriate teams. You will be responsible for responding to HGB in a timely manner on the resolution and impacts, as appropriate
Understanding and engaging in risk management procedures
Oversight of technical written documents such as policies and procedures, program descriptions, end of year analyses, disease specific articles for HGB newsletters, and other disease focused articles as required within the statement of work
Additional duties will include technical writing for policy changes, impact feedback to DHA, and presenting responses to HGB
Minimum of three (3) years of managed care experience
Experience in managing business relationships and handling escalated issues
Experience in Microsoft office products for business presentations
Must be able to prioritize work load, be solution focused, have strong verbal and written skills, and able to keep others on task for deliverables
Proven successful experience in completing efficient health-related research, with associated analysis and conclusions
Bachelor degree in Communication, Journalism, Public Relations, HR, or related degree program
Prior demonstrated experience in Corporate Communications, Internal Communications, Human Resources, or related fields

Humana Behavioral Health Resume Examples & Samples

Direct supervision of Frontline Leaders managing personnel who are providing administration of services to TRICARE beneficiaries under the TRICARE benefit. This includes overseeing seeing the personnel management for the department and participating in personnel hiring, disciplinary actions, performance reviews, etc., for all department personnel unless delegated
Ensure all policies and performance standards in accordance with the URAC, TRICARE Operations Manual (TOM), TRICARE Provider Manual (TPM) or any other Defense Health Agency (DHA) directive are met
Serve as a Tricare Humana Behavioral Health liaison to beneficiaries, guardians personal care managers and providers
Assist Director in determining and implementing new strategies necessary to enhance department efficiency, productivity, and customer service
Serve as a liaison between the Humana Military HBH team and Humana Government Business, other HBH departments, and corporate
Responsible for all utilization management functions, including compliance with URAC, TOM, TPM, and DHA standards
Assist other functional areas with integration of tasks (e.g., QA outcome studies) to meet DHA standards
Perform quality improvement activities such as audits, performance recommendations, and assist Director in preparation for audits by external agencies such as the DHA or the TRICARE Regional Office (TRO)
Ensure productivity levels and/or personnel coachings or other disciplinary actions occur in a timely manner and are documented appropriately for all staff members
Utilize reports and data analytics to develop action plans for identified areas of opportunity including utilization management dashboards, case management and disease management dashboards
Utilize clinical knowledge and experience, identifies, outlines, presents, and leads clinical improvement
Possess a current, valid, and unrestricted license in the State of Texas or possess a reciprocal license from another state. Such licenses are: Licensed Masters Social Worker (LMSW-ACP), Licensed Professional Counselor (LPC), Psychologist (PhD), *Registered Nurse (RN) or other professional license
Minimum of five (5) to seven (7) years of post-degree clinical experience

Director of Behavioral Health Care Integration Resume Examples & Samples

Doctoral degree (PhD) in clinical psychology from an accredited university program
Certified in clinical psychology in Texas or eligible to be certified
At least two (2) years of prior management experience
At least four (4) years of working within a collaborative care structure
A track record of significant funded behavioral health research
Knowledge of state and federal regulations and licensing requirements for ambulatory facilities strongly preferred
Knowledge of budget, billing, finance and managed care rules and regulations preferred
Eligible for a faculty appointment in the Department of Psychiatry, Dell Medical School
Must possess the ability to communicate with others in a clear, understandable and professional manner on the phone and in person; and the demonstrated use of good written and verbal communication skills
Must possess effective project management skills, including the ability to plan, organize and schedule work in an efficient and productive manner, focusing on key priorities and meeting deadlines
Must possess the ability to interact with peers, executives, patient families and other vendors in a manner that represents the Dell Medical School positively
Ability to build and lead high-performing teams; must be able to provide clear and accurate direction and guidance
Must exhibit sound judgment in decision-making
Must possess the ability to maintain regular, reliable and punctual attendance
Must possess the ability to learn and apply new information, knowledge and experiences in a timely manner
Must possess the ability to be flexible and adaptable to change
Must possess the ability to work on multiple tasks and projects and to prioritize
Must possess effective organizational skills and attention to detail; effective follow-through, and commitment to excellence

Humana Behavioral Health Resume Examples & Samples

Create assessment strategies to measure effectiveness of digital learning
Collaborate in the development and implementation of best practices in the use of instructional technologies
Train Humana associates in the use of instructional systems and tools
Investigate and resolve specific problems, emerging learning technologies and instructional methodologies
Advise the learning community on the innovative use and application of technologies in learning curricula
Provide design and production assistance to learning community in developing multimedia and web-based programs using a learning and/or content management system
Use existing content development applications, web-based technologies and user centered design practices in digital learning development
Provide routine backup and storage of instructional materials, programs and research information
Provide technical support for users including software recommendations, hardware troubleshooting and system configurations
Bachelor’s Degree with preference for Master’s degree in Instructional Design, Educational or Instructional Technology or equivalent experience
Prior experience creating instructional materials that demonstrate design skill and are a result of a disciplined process for realizing performance-oriented objectives
Knowledge of Adult Learning Theory, Instructional Design and Blended Learning
Ability to select and design, develop content, create assessments for appropriate mix of delivery methods and media
Strong organizational, interpersonal, communication, and presentation skills
Demonstrated skills in the creation of content across varied delivery modalities
Ability to collaborate independently with subject matter experts
Experience in a clinical setting is a plus
Experience leading and managing instructional design projects
Experience designing live virtual Instructor-Led (ILT) training using WebEx and Microsoft Lync for process/workflow and systems training
Experience creating e-learning using Adobe Captivate 7.0 (and above); Photoshop, Illustrator, Fireworks and Articulate Storyline all a plus
Experience using Adobe Creative Suite

Director of Behavioral Health Resume Examples & Samples

Direct supervision of HBH clinical managers and oversight of these manager’s teams who are providing services to TRICARE beneficiaries under the TRICARE benefit. This includes overseeing the personnel management for the department and participating in personnel hiring, disciplinary actions, performance reviews, etc., for all department personnel unless delegated
Oversight of TRICARE behavioral health case management; disease management; compliance including URAC, TRICARE Operations Manual (TOM), TRICARE Provider Manual (TPM); or any other Defense Health Agency (DHA) directives or standards; and utilization management programs. In addition, responsible for defined outcomes to improve the wellbeing of beneficiaries
Oversight and participation in creating and maintaining medical management policies and performance standards in accordance with the TOM, TPM or DHA directive
Determining and implementing new clinical strategies and innovations necessary to enhance department efficiency, productivity, and customer service
Serving as a clinical liaison between the HBH TRICARE team and Humana Government Business medical management team and other HBH departments
Assisting other functional areas with integration of tasks (e.g., QA outcome studies) to meet DHA standards to include but limited to supporting HGB quality committees as requested
Performing quality improvement activities such as chart audits, peer reviews, and on-site audits, including preparation for audits by external agencies such as the DHA or the TRICARE Regional Office (TRO)
Ability to develop insights from data (QlikView, Excel, or other report format) to identify needs in challenging markets, providers or members that need assistance
Military and civilian healthcare experience
Veteran and/or military lifestyle experience are highly desirable
Desirable: intimate understanding URAC, TOM, DHA requirements
Experience in a wide variety of case management, to include family issues, Substance Abuse Disorders, Autism Spectrum Disorders, Traumatic Brain Injury, and Post Traumatic Stress Disorder, Eating Disorders

Behavioral Health Service Coordinator Resume Examples & Samples

Identify special needs members through the completion of health screens and other resources
Work with community outreach/member advocates to coordinate member care
Educate PCP’s, members, medical consenters, and caregivers on behavioral health issues including symptoms, relapse prevention, stress reduction and healthy lifestyle choices

Behavioral Health Telehealth Rn-arizona Licensure Required Resume Examples & Samples

Possess and maintain a thorough grasp of clinical knowledge (i.e. pertaining to various disease states, medications, treatments, etc)
Comply with Federal and respective state’s laws regulating health management organizations and telephone information centers
Comply with all department standards and policies and procedures
Maintain clinical assessment skills and required licenses and CEUs
Apply primary nursing knowledge while performing all aspects of assigned tasks
Conduct thorough and sound nursing assessments of callers’ presenting symptoms
Develop, implement, and evaluate a plan of care for each caller presenting symptoms
Answer all calls in a timely manner
Interact with callers and other staff in a polite and courteous manner
Maintain confidentiality of all caller and personnel issues
Document all call inquiries according to department policies and procedures
Participate in the collection of data for department QI/QA projects
Make manager aware of any situation that may effect the performance, morale, or safety of the department, or its staff members
Work effectively with coworkers to maintain and improve operation
Participate in staff meetings and trainings
Promote recovery concepts and inspire hope
Graduate certificate from an accredited nursing program
Must have at least one year of full time Behavioral Health Nursing experience
Prefer at least five years of experience in Behavioral Health Nursing or related positions
Current RN license without restriction in the state of residence
Expected to secure and maintain additional professional licenses in required states as determined by the business unit
Strong computer skills required, including experience with Microsoft office and data entry systems
Experience in telephonic counseling and/or managed care setting preferred
Bilingual in Spanish highly preferred

Bwpo Behavioral Health Resume Examples & Samples

Provide referral/community resource assistance to patients identified by the clinical staff
Develop expertise in available Behavioral Health resources in particular geographic and illness areas
Research, confirm, update and maintain the Community Resource Database with resources available for adults with behavioral health needs, including outpatient individual or group therapy programs, partial hospital programs, dual diagnosis and inpatient programs
Communicate effectively with payers in order to find most accessible providers for patients, taking into account coverage, geography, and availability to accept new patients, etc. Refer patients and their families, who need assistance, to the appropriate educational resources regarding health care delivery and reimbursement, prescription drug programs, health and wellness programs, long term care insurance, asset and legal management, government programs, community agencies, public and private organizations, housing options, and other services, as appropriate
Work with patients to ensure their identified community resource needs are met i.e. legal, financial or other
Support teams on meeting patient’s health goals
Proactively develop and maintain partnerships with local community-based agencies and programs
Research resources and programs available for patients and their caregivers including but not limited to: disabled and elder housing assistance and programs; legal, financial and insurance resources; substance abuse programs; health education material
Maintain the resource database and regularly update staff on new information
Participate in regular interdisciplinary team meetings to develop strategies for better supporting patients with complex care needs
Work collaboratively with Social Workers and other staff to support patients which may include, but is not limited to: finding support systems for patients experiencing grief or bereavement; identifying and referring patients to community services such as transportation, Meals on Wheels, day programs; and the coordination of referrals to internal and external resources and referring to social work when concerns warrant further assessment and/or an abuse or neglect report
Act as a liaison between care teams and community groups and foster relationships with key contacts in those groups
Maintain patient confidentiality in all matters
Participate in process improvement groups
Occasional community agency site visits to enhance collaborative partnerships with agencies
Associate’s or Bachelor’s Degree in social work, psychology (or related field)
Demonstrated experience working with diverse and at-risk populations
Strong interpersonal and communication skills
Flexibility to adapt to program evolution and shifts in prioritization
Goal-oriented and accountable in a complex medical environment
Demonstrated organizational and time management skills
Proficient in Word, Excel
Customer focused and patient-centered
Enjoys being part of a diverse team
Comfortable with change
Must have strong interpersonal skills
History of being highly organized, effective multi-tasker, self-motivated and self-directed
Assessment and problem solving skills
Ability to identify patient’s needs and coordinate with community based services
Ability to respond to patient’s resource needs and coordinate with community based services
Strong written and oral communication skills
Professional demeanor with patients, family and team
Ability to represent the care team and maintain and build relationships in the community
Interpersonal skills to interact professionally with various levels of staff, patients, families and community organizations
Must be able to participate effectively in a multidisciplinary team setting
Spanish language skills preferred but not required

Integration Behavioral Health Provider Resume Examples & Samples

Provides case-by-case assistance and consultation on mental health issues affecting patients; assists medical staff by indicating the degree and severity of emotional factors adversely affecting patients. Documents all interventions in the patient medical record both timely and accurately
Conducts brief screenings, based on medical provider referrals, to evaluate the needs of adults, adolescents, and children for behavioral health intervention, case management, or ongoing mental health or addiction treatment. Provides referrals for more intensive services where appropriate
Provides short-term behavioral interventions to engage and motivate clients to actively manage their medical and behavioral health care. Conduct follow-up as appropriate based on assessment and treatment
Participates in ongoing training in behavioral health issues and provide consultation and training to primary care clinic staff in mental health topics including counseling skills, medication use and misuse, substance abuse, wellness, rehabilitation, recovery and self-sufficiency
Establishes and maintains a current listing of community linkages to meet the needs of the target population. Develops and maintains collaborative working relationships with community providers of adult services. Initiates linkages, disseminates information and makes referrals to the appropriate services as needed
Conducts patient satisfaction surveys with all patients receiving behavioral health services under the program. This position also participates in program model development and evaluation, and collects and compiles data as required by program model leads
Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies. Participate in regular multidisciplinary case conferences with medical providers as needed

Behavioral Health Program Manager Resume Examples & Samples

Project leads behavioral health and/or behavioral health home program development and integration activities both internally and externally
Improves quality of behavioral health product by driving cross functional initiatives
Utilizes data to identify and manage change necessary to achieve performance improvement
Communicates and educates associates on behavioral health strategy
Develops behavioral health clinical educational materials, and performs provider behavioral health education
Works to develop and enhance relationships within the provider community, including behavioral health homes, community mental health centers, hospitals and individual providers (BH Providers and PCP's) and groups identified that are participating in Physical/ Behavioral integration activities
Designs, develops and implements behavioral health related clinical training for associates and providers
Works with utilization, case and disease management teams to implement and operationalize BH/PH integration iniatives
Educates health plan leadership and cross functional staff on behavioral health and integration strategy ensuring all entiies understand and support the initiatives
Produces professional presentations and training materials to be utlized for training of providers and associates
Manages behavioral health specific policy and procedure development, clinical program descriptions, and other related documentation requirements
Assists with behavioral health provider and/or home provider audits as needed
Assists with analysis of behavioral health utilization data, KPI review and monitoring of behavioral health utilization management metrics. Participates with development of corrective action plans and associated activities for areas that need improvement
Performs duties and responsibilities as assigned
Assist behavioral health home candidates to prepare their organization for becoming Patient-Centered Specialty Practice (PCSP) recognized through NCQA
Oversees compliance with behavioral health home contracts and standards
Required A Master's Degree in counseling, social work, psychology, nursing, or related human service field
Required 5+ years of experience in behavioral health, preferably in public sector
Intermediate Ability to lead/manage others in a matrixed environment
Intermediate Demonstrated project management skills
Intermediate Ability to work independently Ability to work independently or part of a team
Intermediate Ability to work as part of a team
Intermediate Other Strong people skills
Intermediate Other Ability to apply Lean/Six Sigma industry standard application and methodologies preferred
Intermediate Other Comfortable presenting in front of large groups
Intermediate Other Ability to redefine business approaches and processes to meet objectives
Intermediate Other Ability to think outside the box, structure an ambiguous opportunity, determine ROI and build business case for projects
Intermediate Other Possess strategic enterprise wide view while maintaining attention to detail
Required Advanced Practice Registered Nurse (APRN)
Required Licensed Registered Nurse (RN)
Required Advanced Microsoft Word Proficient in Microsoft Office such as Word, Powerpoint, Excel, Project and Outlook
Required Advanced Microsoft Excel Ability to learn company approved software
Required Advanced Microsoft PowerPoint
Required Advanced Microsoft Project
Required Advanced Microsoft Outlook

Supervisor, Behavioral Health Resume Examples & Samples

Supervises daily activities of the behavioral health case management staff ensuring performance standards are met
Implements case management workflows and policies and procedures for integrated behavioral health programs
Performs audits of assessments, care plans and service notes to verify cases are properly established and that member coordination activates are occurring and appropriately documented
Act as a liaison and member advocate between the member/family, physician and facilities/agencies
Conducts performance evaluation, hiring and termination decisions for associates in work group
Reviews time records, sets schedules and approves all vacation/time off requests for subordinate associates
Plays active role in creating, applying and utilizing accepted policies and procedures for case management
Intermediate Ability to create, review and interpret treatment plans
Other One of the following is required
Required Licensed Clinical Psychologist (LCP)

Behavioral Health Clinician PRN CHS Kings Mountain Resume Examples & Samples

Assesses patients� problems, needs, and level of functioning
Writes appropriate treatment plans according to patient diagnosis, age, and clinical presentation
Provides patient care according to established policies/procedures and professional standards of care
Provides accurate and consistent documentation of patient care/response in the medical record
Completes all documentation within facility-established timeframes. Coordinates discharge planning and plan of care with next provider

Lpn-behavioral Health Charlotte ACM Medical Clinic Resume Examples & Samples

Appropriately and accurately documents all patient care/interactions in patient medical record
Participates in telephone triage by obtaining clinically appropriate data and symptoms from the patient and advises and instructs patients according to established protocols and/or orders from the provider
Pre-visit planning with provider and care team
Medication administration, including injections
Check vital signs, height, weight
Assists with patient inquiries for prescription refills, appointment scheduling, and referral authorization as needed
May enter orders in EMR (computerized physician order entry � CPOE) per provider order
Performs venipuncture. May be required to assist with collection of specimens of body fluids such as urine and blood for laboratory testing. Completes lab requisitions and prepares specimens for pick-up
Provides patient with Depart Summary and review at the end of the visit

Clinical Informatics Spec-behavioral Health Administration Resume Examples & Samples

Identifies and recruits subject matter experts into the design and implementation phases of projects within the organization
Participates and leads initiatives within respective facilities to implement solutions and new workflow processes that lead to the clinical transformation of patient care
Enables significant and measurable improvements in population health through a transformed health care delivery system by addressing the goals of meaningful use between the clinical disciplines and Information Services
Participates and leads initiatives in conjunction with administration and quality that require changes in workflow as they relate to the project
Monitors monthly usability and adoption statistics to identify trends and outline action plans to address opportunities to improve meaningful use and quality of care
Works with key customers to develop strategies, manage change, achieve buy-in and compliance of desired workflow
Works with clinical and information services leadership to manage, monitor and audit the changed state
Assumes a leadership role in coordinating change efforts within and across facilities including communication, readiness for change assessment, and policy and procedural changes
Serves as primary facility support for the patient care team during scheduled hours of coverage
Participates and leads initiatives to educate, train, and provide ongoing educational support customers regarding the use of clinical information systems and associated technology
Maintains current knowledge of trends and issues in healthcare, nursing and ancillary practice, healthcare informatics, regulatory and accreditation requirements, organizational policies and procedures, legal implications of the EHR and advances in technology
Participates as required in committees
Participates in project planning/technology

Behavioral Health QI Specialist Resume Examples & Samples

Design, create and implement behavioral Health Quality Improvement projects and initiatives
Conduct and manage outcomes of various studies that may include analyzing, reviewing, forecasting, trending, and presenting information for quality management planning and management needs
Develop and present recommendations and alternatives for management and executive review
Lead and / or mentor associates
Assist in developing department strategic action plans including identification of objectives, goals and strategies
Develop and implement effective analysis, research and evaluation of quality management metrics
Facilitate Quality Meeting
Minimum of Bachelor's Degree
3+ years of behavioral healthcare experience
Previous Experience with New York State OMH (Office of Mental Health ) or OASAS (Office of Alcohol & Substance Abuse) processes and regulations
Previous Experience with SDOH (State Dept. of Health) regulations
Previous Accreditation Experience, I.E. NCQA or URAC standards compliance
Previous experience with quality measures such as HEDIS
2+ years’ experience developing and implementing performance improvement projects, or using data to develop intervention strategies to improve outcomes

Tricare Behavioral Health RN Disease Management Resume Examples & Samples

*This is an office positon located at 2222 W. Dunlap Ave. Phoenix, AZ***
Educating and supporting the individual through telephonic assessment and expert clinical disease management interventions
Assess and interprets beneficiary needs, gaps, and requirements related to his / her disease condition
Develops DM care plan in collaboration with beneficiary / caregiver / provider in order to promote optimal health
Collaborates with specialists, physicians, and medical directors to provide the necessary care and cost efficient care for the beneficiary related to their disease condition
Consulting with colleagues on Bio / Psycho / Social assessments and service plans in a multidisciplinary team
3 years of experience in a hospital setting, acute care, outpatient direct care experience
Telephonic experience required i.e. phone triage, crisis line, disease management or case management
Intermediate experience with Microsoft Word, with the ability to navigate a Windows environment
3+ years of case management experience
Experience in both medical and behavioral settings
Case Management Certification (CCM) preferred or may obtain within 18 months

Behavioral Health Lead-virginia Resume Examples & Samples

Ensure that the MCO’s behavioral health operations, providers, and any subcontractors are in compliance with the terms of the contract
Coordinate all areas of the MCO, including quality management, utilization management, network development and management, provider services, member outreach and education, member services, contract compliance, and reporting
Serve as the primary behavioral health contact for United Healthcare Community Plan of Virginia to address routine and complex member issues/concerns
Own account performance (against both utilization and financial targets)
Ensure the timely completion of all behavioral health contract deliverables including the collection and delivery of required reporting
Establish strategic priorities for Benefit Expense Management/Population Health Management, and Medical-Behavioral Integration
Identify and analyze utilization and cost trends, and develop mitigation initiatives in coordination with clinical operations functional leads and other matrix partners
Lead the development of any account required clinical processes (i.e. development of job aids, QRGs)
Serve as behavioral health leader in customer, state, and Community Service Boards’ meetings
Interacts closely with state departments, providers and other stakeholders
Works closely and collaborates with Clinical Operations directors, managers and supervisors in the effective delivery of services to ensure utilization and customer goals are met
Is a physical presence in the community with community providers, state agencies, advocacy agencies/groups
Lead/and/or participate in local/national clinical projects that result in the development or improvement of local clinical services and/or access to care
Routinely interface with Account Management to ensure contractual obligations and market expectations are being met
Support recruiting and onboarding clinical operations new employees
Ensure strong collaboration and coordination between physical and behavioral health care
Must have minimum of a Master’s degree in psychology, counseling or social work or a Bachelor’s degree in nursing; and must have a valid independent VA clinical license in counseling or social work, be a Licensed Psychologist or Nurse Practitioner, or a registered nurse (RN) with a minimum of 3 years psychiatric service experience
Minimum five years of experience in public sector or behavioral healthcare
Prior experience in public sector mental health or non-profit community mental health, with knowledge of Medicaid populations
Strong report writing capability
Experience in recovery and resiliency practices and programs
Minimum eight years of leadership and administrative experience
Thorough understanding of managed care principles, models and financing required with a minimum of two years of experience working in a corporate managed health care environment

Behavioral Health Navigator Resume Examples & Samples

Provide a workable strategy to effect change by facilitating or recommending appropriate referrals or preventative services, treatment and support for populations with alcohol, drugs or substance abuse
Evaluate psychiatric patients in the Emergency Department and make recommendations to the Emergency Department Physician as to the disposition of those patients
Oversight and management of the external Emergency Mental Health Crisis Teams that evaluate patients in Steward Emergency Departments
Competent in face to face private, confidential interviews with patients to assess the needs of patients from referrals directed by the Emergency Department physicians/staff. Documents the initiation of these referrals in the patient's medical record
Confers with related health professionals in relation to the need for interdisciplinary information sharing and treatment planning. Uncovers barriers to care and develops an effective plan for alleviating these barriers to care for the safety ad betterment of the patient
Provide individualized psychotherapy, supportive counseling and group therapy as needed
Responsible for documenting assessments, interventions, plans and related to the patient's confidential medical record in accordance with HIPPA, industry, and compliance standards
Educate PCP's and clinical staff on alternative care management options
Demonstrate effective leadership skills
Provide education/consultation as needed to other mental health care team members and to health care consumers
Maintain current up to date knowledge of regulatory requirements
Actively maintain a valid license to practice behavioral health independently in the state of MA
Initiate & follow through with necessary patient contact, support and administrative functions to ensure
Collaborate with other agencies for the education and benefit of the staff and hospital
Perform analysis and report of various metrics as requested
Participates in and or represents Community Health in community/hospital board/committee meetings as needed. Completes/leads assigned Community Health Projects as directed
Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional, responsible and courteous environment

Behavioral Health Navigator Resume Examples & Samples

Master's Level Clinician skilled in the Assessment, Diagnosis and Disposition of Behavioral Health patients
Knowledgeable about services available to Behavioral Health Patients
1-2 year's direct experience required
Master's degree (MA, MS, MSW) or Doctorate in Psychology or Social Work,
Licensure at the independent level in the state of Massachusetts
Licensed Psychologist, Licensed Independent Clinical Social Workers (LICSW) or Licensed Mental Health Counselors (LMHC)
Computer skills are essential

Behavioral Health Clinician Sign On Bonus of Resume Examples & Samples

Provide brief evidence-based direct care to patients
Masters or Doctoral Degree in Social Work or Psychology
Licensed Social Worker (LICSW), PsyD, or Doctoral Level Licensed Psychologist (LP)

Behavioral Health Clinician Resume Examples & Samples

Complete diagnostic evaluations
Provide consultation to the team regarding diagnostic impressions, recommendations, and strategies to engage patients in health and behavior change
Support the team with the day to day management of complex patients
Engage in population health activities to support risk stratified populations
Licensed Independent Clinical Social Worker (LICSW), Licensed Marriage and Family Therapist (LMFT) or Doctoral Level Licensed Psychologist (LP)
2 years post licensure experience within a primary care or medical setting

Behavioral Health Pain Specialist Resume Examples & Samples

Masters or Doctoral Degree in Social Work or Psychology with emphasis on clinical practice
Licensed Social Worker (LICSW), PsyD, or Doctoral Level (PsyD or PHD) Licensed Psychologist (LP) in the state of MN
Experience providing diagnostic assessments and direct evidence-based clinical services to adults

Case Manager Behavioral Health Resume Examples & Samples

Assists with assessment/triage as well as outpatient and concurrent review while managing the case
Provides case management and support that requires clinical expertise in various systems with focus on helping the family negotiate the complexities involved with a diagnosis (i.e. school system support, local centers of excellence, state advocacy services, local chapters and support groups, family evaluation, and support for work-life)
Facilitates member and caregiver education and involvement of caregiver in the delivery of interventions
Provides advocacy and support to family members
Promotes, coordinates and facilitates collaboration among all parties, including external care management organizations to achieve stated goals
Creates and maintains appropriate clinical records
Fully licensed to practice in this State at the Master's or Doctorate level as a Clinical Social Worker, Marriage Family Therapist, Professional Counselor or Psychologist without restrictions or supervision at the highest independent level. Must have and maintain a current, valid and unrestricted clinical license
Minimum three years clinical experience in behavioral health
Three years experience in Care/Case Management
Previous Managed Care experience
Past experience providing utilization review or case management

Humana Behavioral Health Large Practice & Ancillary Contracting Executive Resume Examples & Samples

Facilitate provider education, training them in order to increase their familiarity and satisfaction with Humana’s systems and strategies
Interface with market leaders to align contracting needs and business efforts
Bachelor’s Degree in Business, Finance or a related field or a minimum of 2 years’ relevant provider contracting/provider relations experience
Prior demonstrated success in provider contracting with both large physician groups and ancillary providers
Proficiency in analyzing, understanding and communicating financial trends
Working knowledge in the areas of Group Practice Management, Long-Term Acute Care, home health, home infusion, behavioral health, ambulatory surgery, and the outpatient experience

Director of Behavioral Health Resume Examples & Samples

A medical degree and graduate psychiatric education as defined in Section 623 and a California license as a physician with two years of training or practice in psychiatry, one year of which is administrative
A doctorate degree in psychology and a California license as a psychologist, with three years of clinical psychology experience, two of which are administrative
Master’s degree in social work and California license as a Clinical Social Worker, with five years of mental health experience, two of which are administrative
Master’s degree in behavioral sciences and a California license as a Marriage, Family, and Child Counselor with five years of mental health experience, two of which are administrative
Master’s degree in psychiatric or public health nursing and a license as a Registered Nurse in California and five years mental health experience, two of which are administrative
Master’s degree in hospital administration, public health administration or public administration and at least three years experience, two of which have been in mental health

Operations Director, Behavioral Health Resume Examples & Samples

Maintains adherence to contracted performance standards for areas of responsibility
Ensures timely delivery on contracted customer commitments within functional areas
Primary interface responsible for working collaboratively with corporate enterprise functions including eligibility, claims, call and alerting utilization/care management to ensure contract commitments and local needs are met and issues are resolved
Manages vendor relationships
Oversight of performance for member/provider services and crisis line
Ensures effective delivery of services, meeting goals and ensuring contract compliance
Guides staff in the effective delivery of services, meeting goals and ensures contract compliance
Designs appropriate communications, training and performance support materials
Monitors compliance with established performance standards, assists teams in identifying performance issues, generates solutions for identified problem areas and drives action plans to maintain compliance with performance requirements
Uses data to identify trends, patterns, issues and opportunities that have an impact on the business and uses the data to help make sound business decisions/recommendations
Prioritize initiatives and educational efforts to ensure urgent and important issues are addressed promptly and resolved; successfully drives to excellent results and meets or exceeds goals
Supports the executive director and other leaders in supporting daily operations
Business owner for DRG reporting processes
Master’s degree in business, health administration, psychology, social work, nursing or related professional field a plus
Experience with large matrix organization

Senior VP-behavioral Health Clinical Product Management Resume Examples & Samples

Creation and Implementation of Optum Behavioral Health Key Strategies that include 33 million lives
15+ years of strategic and / or operational experience, leading large - scale projects / programs with complex transformational or new business design components healthcare industry experience
Prior experience working with successful utilization and care management models
5+ years of strategic consulting experience within external consulting firm
Advanced level of proficiency with MS PowerPoint and Excel
Prior experience developing and presenting information to senior leaders
End to end business process thinker
Prior experience leading operations integration and process integration
Graduate degree
Large matrix organizational experience

Care Manager EAP & Behavioral Health Ca-huntington Beach Resume Examples & Samples

Coordinates care between medical and behavioral health vendors, as well as different care levels of behavioral health care; also coordinates services with community resources for both behavioral health and EAP; follows up to ensure community based referrals are being utilized
Manages cases and clinical requests for services to ensure that the beneficiaries’ clinical needs are met at the most cost effective and clinically appropriate level. Monitors timeliness of all clinical and administrative decisions to meet regulatory and accreditation standards
Reviews, coordinates, and makes recommendations with other Care Managers, Sr. Care Managers, Medical Directors, and Clinical Managers as appropriate
Ability to function on a team with cooperation, flexibility, and willingness to assist others
Excellent planning, organizational, and prioritization skills

Integrated Behavioral Health Provider Resume Examples & Samples

Provide patient and family education effectively and sensitively to encourage compliance with medical and behavioral regimes
Effectively utilize a brief consultation model to communicate with the primary care physician. Provide consultation and training to other members of the primary care team in the area of mental health, chemical dependency, and behavioral medicine
Possess skill and expertise to discuss common psychotropic medications with a patient, including indications, effects and side effects and demonstrate the ability to appropriately recommend initiating medication to primary care physician
Possess knowledge about adult and pediatric screening instruments for and consult with primary care team on a depression management program in primary care
Performs clinical, compliance, and administrative duties related to Medicare billing
Two (2) years of post master's practice experience under appropriate supervision in brief assessment and intervention with children and adults in a primary care outpatient setting
Brief assessment and or intervention or integrated care with patients 65 yo and older

Manager, Behavioral Health Psychology Resume Examples & Samples

Has counseling/disciplinary responsibilities; conducts performance evaluations; responsible for allocation of resources; has overall personnel management responsibility (HR, personnel, compensation issues)
Generally over a larger team , such as Adult/Child or CDS
Responsible for overall program design and operations within unit
Minimum of two (2) years professional experience under the direction of a licensed psychologist or board certified psychiatrist
Previous clinical responsibilities to include psychological testing, diagnosis, crisis intervention, brief individual and group psychotherapy
PhD, PsyD, or EdD in clinical or counseling required from an accredited college or university
Current valid license to practice psychology in the State of California
Must have a National Provider Identifier (NPI), or obtain an NPI, prior to employment start date
Knowledge of social service agencies, state regulations and APA standards as it related to client treatment, patient rights and client/patient confidentiality
Knowledge of psychological testing techniques, administration and interpretation

Manager, Behavioral Health PSW MFT Resume Examples & Samples

Makes budget recommendations
Generally responsible for a small group or program such as IOP/Adolescent/Crisis Team. Responsible for program design and implementation within unit
Monitors access indicators: responsible for utilization management
Minimum two (2) years of post license, paid experience as a member of a psychiatric treatment team in an outpatient

Manager, Behavioral Health Psychology Resume Examples & Samples

Generally responsible for a small group or program such as IOP/Adolescent/Crisis Team
Responsible for program design and implementation within unit
Minimum of two (2) years of professional experience under the direction of a licensed psychologist or board certified psychiatrist
N/A

Supervisor Behavioral Health Lcsw Resume Examples & Samples

Coordinates, supervises, and monitors daily operations/activities of the BHC Help Line and ensures that high quality services are delivered/provided which increase customer satisfaction and meet purchaser demands
Acts as a liaison/resource to provide education regarding BHC services available to members, purchasers, and outside providers
Monitors BHC Help Line staff member's adherence to clinical standards in their delivery of direct service to members
Advises the Behavioral Healthcare Help Line Manager of areas of potential problems and services not meeting member needs
Provides the Claims Administration Department with resource for retrospective review of psychiatric/addiction medicine claims
Provides the Outside Utilization Case Managers with a resource for resolution of problems with inappropriate Non-KP psychiatric/addiction admissions
Provides additional cross over supervisory responsibilities to include all areas of the Case Coordination Center
Minimum three (3) years of psychiatric and Addiction Medicine clinical experience as a Registered Nurse and/or Clinical Social Worker
Minimum two (2) years of relevant Supervisory experience
Minimum two (2) years of Utilization Case management experience preferred
Knowledge of KP BHC services highly preferred

Care Manager EAP & Behavioral Health Tx-irving Resume Examples & Samples

Familiarity with Managed Care policies and procedures
Familiarity with community resources
Ability to identify Potential Quality Indicators using criteria established by the QM department

Behavioral Health Service Manager Resume Examples & Samples

Master's degree in Behavioral Health
LCSW, LMFT, LPC, PhD, PsyD or RN license
Minimum 3+ years of case and/or utilization management experience
Current experience in psychiatric health care settings, child behavioral health conditions and members with special needs
Working knowledge of utilization review procedures, and familiarity with mental health community resources
Thorough knowledge of a specialized or technical field such as clinical nursing, case and/or utilization management involving knowledge plus the application of basic theory
Current experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff
Foster care experience strongly preferred

Psych Tech-inpatient Adult Behavioral Health Resume Examples & Samples

Responsible for working knowledge of hospital’s emergency procedures; assists in providing a clean and safe environment
Engages in therapeutic conversation with patient and interacts with them in accordance with appropriate therapeutic boundaries
Accompanies patients off unit as ordered for tests, visitation, walks, etc, as staffing and milieu allows
Knowledge of medical office practices and procedures, office equipment, medical terminology, data entry and micro-office software preferred in clinic setting
Proof of completion of Mandatory Reporter abuse training specific to population served within three (3) months of hire

Behavioral Health Emergency Clinician Resume Examples & Samples

Excellent written and verbal communication skills, along with excellent interpersonal communication skills
Ability to perform multiple tasks simultaneously, apply critical thinking process
Ability to formulate diagnostic impressions based upon review of systems, history, symptoms, and current presentation
Respond to all customers using AIDET, iCARE, and knowledge with Trauma Informed Care

Regional VP Behavioral Health Services Resume Examples & Samples

Firm grounding in principals of behavioral health administration and be capable of organizing, managing, promoting, and evaluating all related services
Masters Degree in behavioral sciences, administration, business or healthcare related field or nursing degree a preference
Successful tenure as a CEO of Behavioral Health Facility 3 years (Minimum)
5 years in senior leadership position within behavioral health setting (2 years related to med/surg hospital setting preferred)

Manager of Behavioral Health Resume Examples & Samples

BSN and MSN preferred or equivalent experience
Minimum of 3-5 years nurse practice experience
Crisis Prevention within 60 days of hire
ACLS - American Heart Association - preferred
Previous management experience - preferred

Lead Behavioral Health Emergency Clinician Resume Examples & Samples

Excellent written and verbal communication skills, along with excellent interpersonal communication and proven leadership skills
Must be knowledgeable on tele-medicine processes, technologies, and best practices within tele-mental health
Drive and desire to interact with professionals on all levels of the healthcare team
Actively participate with Administration to accomplish the goals and plans of the department
Ability to work in high acuity and stressful environment
Ability to provide crisis intervention and engage multiple systems in diagnostic formulation and disposition

Director, Behavioral Health Lifeline Resume Examples & Samples

Must be able to perceive the nature of sounds with no less than a 40 db loss at Hz 1,000 Hz and 2,000 Hz without correction
Monitors the activities of ancillary personnel
Is customer oriented and uses effective communication skills
Demonstrates leadership and clinical skills pertinent to job

Clinical Coordinator Service Line-behavioral Health Resume Examples & Samples

Minimum 2 years related clinical experience
Current Florida State Registered Nurse License
Critical thinking, service excellence and good interpersonal communication skills, ability to read/comprehend written instructions, ability to follow verbal instructions, PC skills, Proficient in Microsoft Office

Case Manager Prn-behavioral Health Resume Examples & Samples

Registered Nurse with a current California license Current Basic Cardiac Life Support Provider Course
Minimum of two to five years experience in an acute care facility required
Demonstrates excellent communication, written and collaboration skills
Creative in problem solving and systems planning and management
Ability to learn and use computerized patient care management system

Behavioral Health Sales Specialist Resume Examples & Samples

Ability to research, understand, and explain market demographics
Ability to access, understand, and explain physician and key non-physician referral patterns
Ability to plan, organize and manage resources within prescribed timeframes (prioritize and focus)
Ability to present, probe and persuade
Ability to identify and respond appropriately to primary client/customer needs (service orientation)
Ability to demonstrate effective listening and communication skills
Ability to close
Ability to provide follow-up and demonstrate attention to detail
Ability to actively listen to physician and key non-physician referral source practice needs for hospital inpatient and outpatient services

Behavioral Health Admissions Specialist Resume Examples & Samples

Master's Degree in Behavioral Health related field required
3 or more years experience and licensed masters level independent practitioner under the state of TN (LPC, LCSW, & LMFT) required
BLS, CPI certifications required

Financial Planning & Analysis Behavioral Health Leader Resume Examples & Samples

8-10 years financial management experience
Strategic thinking and planning capabilities; excellent organizational skills at coordinating and consolidating inputs across multiple functions
Ability to mentor and manage associates in a constantly evolving environment
Willingness to manage and work closely with an operating team
Prior budgeting, data and financial analysis experience
Comprehensive knowledge of all Microsoft Office applications, Excel
Graduate business degree preferred (MBA, MAC, etc)
Prior management experience in a core finance function
Prior FP&A experience in a large, public, national and/or multi-national environment
Commercial finance expertise
Certified Public Accountant license, desirable
Knowledge of Hyperion Planning
Knowledge of SQL, VBA, SAS, OBIA, Hyperion Essbase and/or Smart View

Behavioral Health Clinical Manager Resume Examples & Samples

Providing clinical case management consultations and clinical guidance for contracted PCPs treating behavioral health-related concerns not requiring referral to behavioral health specialists
Developing comprehensive care management programs for youth and adults with behavioral health concerns, typically treated by PCPs, such as ADHD and depression
Developing targeted education and training for the MCO’s PCPs that commonly encounter behavioral health issues
Using utilization management, care management, quality and other data sources to identify areas of opportunity for implementing population health improvement initiatives for Medicaid members
Ensuring the MCO operates with a recovery based philosophy by working with Recovery and Resiliency team members, modeling behaviors aligned with the Principals of Care and training all staff on practical application of these principles with a focus on: care management, service coordination to address social determinants of health and understanding levels of care
Promotes, identifies and develops opportunities to implement preventative BH strategies that support diversion from more restrictive levels of care
Completes medical necessity reviews for service authorizations in accord with licensure level
Minimum of five years of combined clinical experience in mental health and substance use disorder services and be knowledgeable about primary care/behavioral health integration required
Strong data analysis and organizational skills are necessary required

Rn-geriatric Behavioral Health Resume Examples & Samples

Computer Skills: Input data into computer programs as required by unit
Communication Skills: Answer telephones, Coordinate events, Interview others, Customer Relations
Patient Care Skills: Maintain patient charts

Behavioral Health Service Manager Resume Examples & Samples

Master's degree in Behavioral Health is required
Must have a current unrestricted LCSW, LMFT, LPC, PhD, PsyD or RN license
Minimum of 3+ years of current case and/or utilization management experience
Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff
Foster care experience is very highly desired

Psych Tech-adult Inpatient Behavioral Health Resume Examples & Samples

Participates in Patient Care Conferences whenever possible
Demonstrates working knowledge of psychiatric disorders in defined area of service
Ensures that clinicians are notified promptly of urgent/emergent situations
Conducts routine admission belonging searches and all other searches necessary throughout admission, per unit policy and procedure

Behavioral Health Tech-geriatric Resume Examples & Samples

Basic EKG skills required
Must be able to demonstrate previous work experience following regimented job duties and time schedules when working previously held positions
Willingness to be crossed trained to other areas
Must have and maintain BLS certification. Certification must be in accordance with the curriculum of the AHA, for Healthcare Provider's Program
Must obtain HeartSaver First Aid certification (includes CPR) within 30 days of employment. Certification must be in accordance with the curriculum of the AHA, for Healthcare Provider's Program
Must obtain Satori Alternatives to Managing Aggression (SAMA) certification within 90 days of starting unit orientation
Must be able to travel as needed to STHS facilities

Behavioral Health Tech-adult Resume Examples & Samples

Computer data entry skills required
One year behavioral health or direct patient care experience preferred
Must be able to lead group activities such as group discussions, crafts, games, etc as prescribed
Knowledge of basic practices, procedures and techniques involved in working all populations requiring mental health or substance abuse treatment preferred
Ability to develop and maintain the confidence and cooperation of patients suffering from behavioral health issues communicate clearly and diplomatically with other members of the behavioral health team keep accurate records understand and carry out oral and written directions, computer skills
Must demonstrate commitment and adherence to STHS's Compliance Program and Code of Conduct through compliance with all policies and procedures, the Code of Conduct, attendance at required training and immediately reporting suspected compliance issue(s) to the Compliance Officer
Must obtain Satori Alternatives to managing aggression (SAMA) certification Within 90 days of starting unit orientation

Lvn-behavioral Health Resume Examples & Samples

An LVN currently licensed by the State of Texas
Completion of an IV Therapy Course
De-escalation class within 90 days of hire

NP Behavioral Health Marymount Hospital Resume Examples & Samples

Documents findings in medical record
Develops a treatment plan in collaboration with the physician and members of multidisciplinary care team
Prescribes and monitors medications as allowed by prescriptive authority through the applicable state Board of Nursing and CCF policy. Develops patient education plan

Behavioral Health Tech Resume Examples & Samples

Provides for Patients' activities of daily living (ADL's)
Assists in the examination and treatment of patients under the direction of the Registered Nurse
Identifies physical care and comfort needs of patients, and is able to perform care
Assists with Electroconvulsive Therapy (ECT) preparation and provides care as designated by the Registered Nurse pre-op and post-op
Secures patient belongings and valuables and documents their disposition
Performs ongoing observation of patient's response to illness and treatment which in turn promotes optimal patient outcome
Collects data through observation of the milieu on an ongoing basis
Plans and implements safe milieu interventions consistent with individual patient treatment goals
Assists in the development and the maintenance of an organization/developmental climate in which the needs of Behavioral Health clients are met with warmth respect and responsiveness
Carries out specific interventions to assure patient safety, which includes rounds, primary searches and visitor control
Provides safe environment for the patient on an ongoing basis
Complies with policy and procedure in documentation in multidisciplinary progress notes and in the EPIC system
Documents on patient groups in patient record according to requirements
Documents according to Behavioral Health Medicine guidelines
Actively demonstrates skills in a crisis situation
Demonstrates proper application and maintenance of restraints seclusing of population served under the guidance of the RN
Identifies/utilizes opportunities to update and broaden clinical skills and attends educational in-services voluntarily
Holds self and others accountable for assigned responsibilities
Two years of experience in Behavioral Medicine/Health Field or in Protective Services in a patient care environment required

Behavioral Health Clinical Quality Analyst Resume Examples & Samples

Support the Quality Improvement (QI) program and activities, including the QI committee structure
Coordinate quality projects in collaboration with internal teams and external stakeholders
Assist project teams in identifying performance issues
Manage customer requests related to the quality assurance/compliance monitoring programs
Generate solutions for identified problem areas and driving action plans to maintain compliance with contract requirements
Develop new quality initiatives
Assist in the evaluation of the effectiveness of the quality program
Prepare quality assurance reports
Ensure policy and procedure compliance
Participate in quality improvement audits
Manage quality of care concerns and the reporting of critical incidents
Report on the status of quality projects for senior management
Work on special projects as assigned
Prioritize quality and training initiatives and educational efforts to ensure urgent issues are addressed promptly and resolved
Design appropriate communications, training, and performance support materials
3+ years of experience within a health care and/or behavioral health setting
1+ years of experience quality improvement experience
Intermediate proficiency with MS Office applications specifically MS Word and PowerPoint; able to work in MS Excel
Knowledge of public sector
Familiarity with regulatory and accreditation agencies and their QI requirements, including CMS (Medicaid/Medicare), HEDIS and NCQA/URAC
Excellent verbal (presentation skills) and written communication

Senior Manager, Behavioral Health Product Resume Examples & Samples

Interpret market and client dynamics and develop new product innovations
Evaluate new product ideas - both self-initiated and recommended by clients and business partners - through a product lens (market dynamics, competitive landscape, competencies, value, risks, etc.)
Recommend buy / build / partner solutions for new product opportunities
Lead product development efforts from ideation through execution, partnering closely with stakeholders across the organization and with community partners and government entities to meet customer requirements
Manage existing products; review performance against expectations and facilitate changes to product portfolio or recommend sunset, as relevant
Serve as functional SME on all products in the portfolio - understanding all aspects of product development
Partner with key functional areas to ensure high performance in all areas - operations, clinical value, reporting / measurement, etc
Develop operational plans to contribute to pricing through underwriting for new business opportunities
Support marketing and sales effort through contributions to RFPs, sales training, marketing strategy and materials, and participation in client meetings
Maintain strong communication with all stakeholders, including senior executives and cross - segment partners and external partners
Undergraduate degree in applicable area of expertise
3+ years in healthcare field
5+ years in product, strategy, market management, consulting or other relevant area
Experience working in a large, matrixed organization
Demonstrated ability to influence senior leadership and other stakeholders to adopt new ideas, products and / or approaches
Proven organizational skills with ability to be flexible and work with ambiguity
Highly self - directed with insight into when and how to engage others / manager in key decisions
Experience leading large, complex projects to achieve key business objectives
Demonstrated ability to explain highly complex concepts in ways that can be understood by a variety of audiences
Experience directing cross - functional and / or cross - segment teams
Experience with Behavioral Health, Product Strategy and Development and the Federal marketplace

Senior Director Behavioral Health Medicaid Channel Resume Examples & Samples

Leverage voice of the customer and market insights to manage and improve existing Clinical solutions as well as develop new solutions to grow Optum’s Medicaid business
Develop new ideas and identify opportunities to improve upon Optum’s care programs for the Medicaid market
Influence departmental plans and priorities to address business and operational challenges
Establish success metrics
Partner with Product Leadership to complete product development documentation that will lead to the execution of care management models
Develop final program design specifications in partnership with operations, finance, marketing, relationship office, and other partners
Reviews product performance and develop recommendations to improve
Assess and interpret internal customer, business partner and vendor needs and requirements for program reporting and analysis
Track and report program activities and product change requests at the national and plan level
Work with matrix partners to ensure we are effectively and efficiently delivering on the value promise and agreed targets of existing solutions
2-3 years product management or operations experience
3-5 years Medicaid experience
Ability to think and act strategically and as well as execute tactically with bias toward action
Excellent analytical skills
Experience with Microsoft Excel, PowerPoint, and Word
Medical and behavioral experience
Master's prepared clinical licensure
Demonstrated ability to manage people and prioritize deliverables

Psychiatric Behavioral Health Tech Resume Examples & Samples

Assign the Senior BHTs their specific duties
Act as the patient's advocate and ensure that patient's rights are upheld
Comply with established measures for infection control, OSHA regulations, and risk management
Comply with Service Excellence Policy
Comply with the Employee Code of Ethics
Adhere to all facility and personnel policies and procedures
Consistently reports to work on time and is ready to work at the start of the shift
Clocks in/out per policy and procedure: begins/returns from meal periods and rest breaks within established time frames
Participate in continuous Performance Improvement activities
Balances team and individual responsibilities
Must have no disciplinary actions on file
Consistently demonstrates a self-directed, mature and disciplined approach to completing work duties
Follows proper lines of authority and organizational structure
Knowledge of all code procedures
Knowledge of personal hygiene training techniques
Knowledge of psychiatric care techniques
Knowledge of aggressive behavior management techniques
Knowledge and training in CPR/First Aid
Knowledge of admitting procedures
Knowledge of intake calls

Behavioral Health Service Coordinator Resume Examples & Samples

Work with STAR Kids Members, legally authorized representatives, and providers to meet the behavioral healthcare needs of each member’s condition
Identify STAR Kids members who may benefit from service management, conduct an assessment and develop, implement and monitor an Individual Service Plan
Conduct in-home face to face member assessment and telephonic outreach
Conduct follow-up contacts or in-person visits to determine if services meet members' needs
Update database regularly with most recent Individual Service Plans
Review information submitted by providers into the database to ensure material is appropriate and consistent with guidelines for data inclusion
Encourage behavioral health providers to use evidence-based practices and confirm that behavioral health providers and PCP’s are sharing information as required
Maintain compliance with federal and state regulations and contractual agreements
Coordinate service management functions with other departmental functions
Maintain HIPAA compliance
Educate providers and community resources on program components and available support services
Educate members to foster compliance with program and positively impact outcomes
Education/Experience: Master's degree in Behavioral Health or Registered Nurse required. 3+ years of case and/or utilization management experience
Experience in psychiatric health care settings, child behavioral health conditions and members with special needs
Thorough knowledge of a specialized or technical field such as clinical nursing, case and/or utilization management involving knowledge plus the application of basic theory. Knowledge of utilization review procedures, and familiarity with mental health community resources

RN Adult Psych Behavioral Health Per Diem Resume Examples & Samples

Functions as a milieu therapist to assigned patients, including collaborating with the nurse therapist to determine a milieu treatment approach, functioning as an active member of the multidisciplinary team, administering an initial psychological assessment, and providing consistent individual counseling focused on treatment goals during hospitalization. Participates in milieu therapy for patients on an individual or group basis. Leads or assists in milieu groups. Incorporates knowledge of each patient's condition and application of various therapeutic techniques; ensures appropriate participation by patients
Collaborates with other unit staff in assessing and evaluating patient's mental status. Initiates and maintains a therapeutic relationship with patients. Collaborates in the diagnosis and treatment of patients; shares information and participates in the formulation of treatment plans. Coordinates and implements various aspects of milieu environment to provide a therapeutic experience for patients. Collaborates with other staff members to determine whether a patient represents a risk to himself/herself and/or others. Works with other unit personnel with crisis intervention techniques
Provides supportive care to patients, such as participating in conversation, recreational activities, and basic living activities. This may include assisting patients with bathing, eating, and other daily living activities. Sets limits, confronts counterproductive activities and behavior, and reassures and orients patients. Encourages and facilitates appropriate interactions between patients
Provides support and education to family members and significant others regarding the patient's status. Works with representatives of outside agencies in obtaining or disseminating information on individual patients. Participates in discharge planning and referral, if necessary

Behavioral Health Clinician Resume Examples & Samples

Complete diagnostic evaluations
Provide consultation to the team regarding diagnostic impressions, recommendations, and strategies to engage patients in health and behavior change
Support the team with the day to day management of complex patients
Provide brief evidence-based direct care to patients
Engage in population health activities to support risk stratified populations
Masters or Doctoral Degree in Social Work or Psychology
Licensed Social Worker (LICSW), PsyD, or Doctoral Level Licensed Psychologist (LP)
2 years post licensure

Executive Director Behavioral Health Resume Examples & Samples

Coordinates day-to-day BH operations to achieve goals and ensures smooth and efficient functioning to meet the requirements of State of Louisiana
Interacts closely with State of Louisiana, providers and other stakeholders in the success of the BH program
Ensures the timely completion of all BH contract deliverables
Guides directors, managers and supervisors in the effective delivery of services, meeting goals and avoiding all contract penalties
Oversees the clinical and administrative supervision of staff
Participates in all required meetings
Ensures collaboration and coordination with all stakeholders
Oversees hiring, promotions and disciplinary actions to assure adherence to human capital policies
Formulates action plans to remedy any findings from the provider audits, utilization reports, provider concerns or in response to State of Louisiana concerns
Demonstrates an effective, adaptive leadership style that promotes innovation and accountability and establishes work priorities; delegates pertinent activities
Develops reviews and approves documents which provide information and program justification
Represents UnitedHealthcare in relevant organizations and meetings
Provides leadership and direction in the development of appropriate risk management strategies. Works closely with State of Louisiana, providers and stakeholders to implement these strategies
7 years of managerial and administrative experience in public sector or Behavioral Health Care
Thorough understanding of managed care principles, models and financing
Demonstrated leadership effectiveness and project management experience
Strong customer service orientation and experience in recovery and resiliency practices and programs
Strong data analysis and PC proficiency
Demonstrated abilities to build effective teams facilitate staff working together collaboratively and retaining top talent
Exceptional planning, organization and monitoring skills
Administrative experience in the Louisiana mental health and substance abuse service delivery system and in administering a similar contract
Experience working in a corporate managed health care environment

Behavioral Health Integrated Care Manager Resume Examples & Samples

Engage members telephonically using clinical skills to coordinate physical and behavioral health service needs
Deliver an integrated approach to coordinated care based on the member’s needs
Identify early risk factors and conduct ongoing assessments
Coordinate physical services as needs are identified (home health, DME, etc.)
Decrease unnecessary hospitalizations and ED visits
Attend monthly meetings with the assigned AZ Regional Behavioral Health Authorities (RBHA)
Current, unrestricted RN license or LCSW/MSW in the State of Arizona
3+ years clinical, behavioral or case management experience
Ability to prepare and document case summary’s
Independent self-directed
Medicare / Medicaid experience

Director, Behavioral Health Services Resume Examples & Samples

Serve as Clinical and Affordability lead in monthly / quarterly JOCs and other ad hoc customer and state meetings
Works closely and collaborates with Clinical Operations directors, managers and supervisors in the effective delivery of services and to ensure utilization and customer goals are met
Demonstrates an effective, adaptive leadership style that promotes innovation and accountability and establishes work priorities
Act as the primary BH clinical source for the Customer, State and other Stakeholders to address routine and complex member issues / concerns. As required by Contract, be a physical presence in the community with community providers, state agencies, advocacy agencies / groups
Lead and / or participate in local / national clinical projects that result in the development or improvement of local clinical services and / or access to care
Routine interface with BH Network to ensure access to care meets the needs of the membership
Possesses an active, independent, and unrestricted behavioral health licensure and certification from the state or board which issued the credentials
Thorough understanding of managed care principles, models and financing required; with a minimum of 2 years of experience working in a corporate managed health care environment strongly preferred
5+ years of leadership and administrative experience in public sector or BH care
Experience in a recovery-oriented delivery system
Prior experience making oral presentations

Behavioral Health Services Manager Resume Examples & Samples

Maintains 20% clinical schedule
A broad range of clinical experience preferred
Affiliation with National Association of Social Workers preferred

Dir, Behavioral Health Resume Examples & Samples

Drives behavioral health programs through the development of policy and procedure, clinical criteria, workflows and other behavioral health documentation
Monitors processes and procedures to ensure compliance with contractual, regulatory (Federal/state) and accreditation entities
Provides leadership and support to front-line staff and supervises
Provides guidance to Behavioral health management for future expansion and growth efforts
Coordinates quality assurance and quality improvement activities with regional and corporate departments
Assists with development of member and provider education tools and materials
Assists with development of clinically-focused training associated with behavioral health assessment, care plan development and behavioral health services in the state
Assists in establishing effective operational practices and works closely with various health plan departments and regulatory agencies to ensure contracts meet operating, financial and legal standards
Performs data analysis and develops specific actions to manage medical cost trends
Establishes, maintains and fosters professional working relationships with all behavioral health providers and develops regular ongoing working relationship with the community mental health system in the market including community mental health centers, treatment facilities and other significant behavioral health providers
Partners and collaborates with other departments and the corporate office regarding behavioral health matters and initiatives
Oversees the day-to-day operations for behavioral health associates which include activities designed to achieve quality of work products and outcomes of individual performers
Serves as a community liaison and leader for community advisory boards, advocacy groups, task forces or other community-based stakeholder activities
Required 8+ years of experience in behavioral health management and/or acute behavioral health care setting focusing on outpatient/inpatient utilization, case management and discharge planning
Required 5+ years of management experience
Required 4+ years of experience in a managed care environment (as a licensed mental health professional)
Required Other Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
Advanced Ability to effectively present information and respond to questions from peers and management
Advanced Ability to lead/manage others
Advanced Demonstrated organizational skills
Required Intermediate Financial Management Systems (Generic)

Behavioral Health Clinical Specialist Resume Examples & Samples

Proficiency in all Microsoft Office applications, including Word and Excel
Ability to juggle multiple tasks at once
Bachelor's degree in related field preferred
Minimum of one (1) year of managed care experience or related behavioral health
Familiarity with medical terminology and/or ICD-9 codes

Behavioral Health Service Manager Resume Examples & Samples

Work with Foster Care Members, Medical Consenters, Department of Family and Protective Services (DFPS) staff and providers to meet the behavioral healthcare needs of each foster care member’s condition
Identify foster care members who may benefit from service management, conduct an assessment and develop, implement and monitor a healthcare service plan
Provide information to DFPS staff to facilitate development of the DFPS case plan
Update database regularly with most recent Service Management Plan of Care
Comply with established referral, pre-certification and authorization policies, procedures and processes by related medical management staff
Monitor data to address trends or potential quality improvement opportunities
3+ years of case and/or utilization management experience
Candidates are required to have the license to practice independently, and/or have obtained the state required licensure as outlined by the specific state. This includes but is not limited to licenses such as LPC, LCSW, LMFT, LMHC, LIMHP, and RN

Behavioral Health Director Resume Examples & Samples

Responsible for oversight, tracking and reporting clinical requirements and performance standards set by the Customer and the State
Establish strategic priorities for Benefit Expense Management, and overall affordability initiatives
Identify and analyze local market trends, service gaps and the development of mitigation strategies aligned with our strategic priorities
Responsible for defining and developing local market-specific mitigation strategies in coordination with clinical operations functional leads, Affordability, Finance and other matrix partners
Monitor and oversee local market performance (against both utilization and financial targets to ensure targets are met
Collaborate with Clinical Operations for any market required clinical processes. (i.e. development of job aids, QRGs)
Serve as Clinical and Affordability lead in monthly/quarterly JOCs and other ad hoc customer and state meetings
Collect, and deliver required clinical operations customer reporting as well as develop action plans to address performance issues
Collaborate and coordinate with state, providers and other stakeholders in conjunction with the Executive Director and Relationship Office
Ensures the timely completion of all clinical contract deliverables
Act as the primary BH clinical source for the Customer, State and other Stakeholders to address routine and complex member issues / concerns
As required by Contract, be a physical presence in the community with community providers, state agencies, advocacy agencies / groups
Routine interface with the Optum Relationship Office to ensure contractual obligations and market expectations are being met
As required by Contract, conduct / attend ad hoc trainings with provider community as requested
As required by Contract, lead and / or participate in provider forums as needed
Possesses an active, independent, and unrestricted behavioral health licensure in the state of Iowa and certification from the state or board which issued the credentials or 5 years of leadership and administrative experience in public sector or BH care required
Thorough understanding of managed care principles, models and financing; with a minimum of 2 years of experience working in a corporate managed health care environment a plus

Behavioral Health Utilization Review Analyst Resume Examples & Samples

Evaluates and intervenes concurrently and retrospectively for level of care, coverage issues, payor outliers, split billing, disallowed charges, patient inquires, denial and compliance issues
Initiates actions and participates with Patient Financial Services payor teams regarding resolution of denial management issues or compliance issues. Works with authorized payors or reviewers to resolve denial management issues, reconsiderations and appeals
Tracks, monitors and documents denial causes and resolutions with appropriate management staff
Acts as a knowledge resource for billing staff members. Identifies educational needs regarding payor issues, functions as preceptor, and provides appropriate education
Builds and continually updates a knowledge of Third Party Payor requirements for covered treatment protocols by diagnosis, approval requirements for procedures, and coverage norms
Provides education by collaborating with Care Coordination at company facilities or other staff of non-company locations on concurrent and retrospective utilization review. Accurately and thoroughly completes documentation required for claims payment of services approved through concurrent review and case management

Dshs Behavioral Health Program Manager Resume Examples & Samples

Chemical Dependency Professional License (CDP)
Experience working in the field of Substance Use Disorders
Experience working with a Managed Care system
Experience and knowledge about the state Medicaid system
Understanding of clinical, developmental and social issues affecting youth and adults in public substance use disorder systems
Knowledge of Washington State's substance use disorder system, including inpatient and outpatient care, systems and coordination of treatment
Knowledge of managed care principles, contract issues, access to care, medical necessity, resource management, quality improvement, cultural competency and provider contracting including priorities and rules related to federal funding
Knowledge of the Washington State Centennial Accord and the Government-to-Government relationships with Federally Recognized Tribes and Recognized American Indian Organizations
Knowledge of protocols and processes of the executive and legislative branches of state and local governments
Ability to work collaboratively with multiple stakeholders including consumers, providers, state and local government officials and legislative staff in the development of policies and procedures, WAC and statutes
Ability to plan, collaborate, analyze and problem solve with clear goals and objectives regarding system service gaps and policy needs
Ability to work across systems to develop improved coordination of care for individuals with multiple needs
Knowledge and experience in project management, processes, leadership and execution
Ability to lead meetings, facilitate workgroups and represent division/department management positions
Knowledge and understanding of the legislative process

Behavioral Health Services Clinical Manager Resume Examples & Samples

Requires Master’s degree in Social Work or other clinical related field with licenser in Indiana
BLS Certification must be maintained throughout employment with Terre Haute Regional Hospital
Crisis Prevention Certification training completion within 6 months of hire and maintenance of certification throughout employment with Terre Haute Regional Hospital
2 or more years in a leadership role
2 or more years of inpatient acute care experience

Care Manager EAP & Behavioral Health Hours per Week Afternoons & Weekends Tx-irving Resume Examples & Samples

Provides referrals to outpatient providers and facilities per member requests
Works with WorkPlace Options and/or other vendors to support EAP members accessing any necessary work/life benefits and services
Self-starter with good problem solving skills

Care Manager EAP & Behavioral Health Irving Resume Examples & Samples

Handles and processes crisis calls; analyzes complex cases; screens members for care coordination needs; makes innovative use of available resources
Actively participates in clinical staff meetings with Team Supervisor and MHN’s board-certified Medical Directors

Behavioral Health Resume Samples

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