Behavioral Health Resume Samples

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AS
A Schinner
Ashleigh
Schinner
82052 Fadel Path
Chicago
IL
+1 (555) 736 4072
82052 Fadel Path
Chicago
IL
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
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

1

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
2

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
3

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
4

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
5

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
6

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
7

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
8

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
9

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
10

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
11

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
12

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
13

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
14

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
15

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
16

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
17

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
18

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
19

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
20

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
21

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
22

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
23

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
24

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
25

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
26

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
27

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
28

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)
29

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
30

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
31

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
32

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
33

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
34

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
35

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
36

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
37

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)
38

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
39

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
40

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
41

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
42

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
43

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
44

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
45

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
46

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
47

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
48

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
49

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
50

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
51

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
52

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
53

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
54

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
55

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)
56

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
57

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
58

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
59

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
60

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
61

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
62

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
63

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
64

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
65

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
66

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
67

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
68

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
69

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
70

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
71

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
72

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
73

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
74

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
75

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
76

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
77

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
78

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
79

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
80

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
81

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
82

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
83

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
84

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)
85

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
86

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
87

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
88

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
89

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
90

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
91

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
92

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
  • Identifies appropriate members and provides care coordination services for these managed care beneficiaries
  • Demonstrated ability to assess, evaluate, and integrate clinical data
  • Knowledge of Managed Care benefits and eligibility
93

Care Manager EAP & Behavioral Health Hours per Week Afternoons Resume Examples & Samples

  • Communicates with both internal and external customers. Educates providers, members and beneficiaries regarding benefits, services, and resources. Provides care shaping (working with providers to shape care) with providers and facilities to support best outcomes for members
  • Identifies Potential Quality Indicators using criteria established by the QM department. Reports and resolves any potential member complaints or grievances
  • Computer literacy
  • Ability to function professionally under pressure
  • Demonstrated communication and interpersonal skills
94

Behavioral Health Resume Examples & Samples

  • Traveling up to 75% of the time to conduct on-site facility, agency, and clinician audits throughout a given region
  • Working to ensure our members receive the best possible treatment from a network of high-quality clinicians and facilities
  • Attending team meetings by phone to stay up-to-date on issues and discuss inter-rater reliability
  • Developing your own travel schedule
  • Sending letters and samples of audits to providers
  • Scoring audits and writing audit reports
  • Tracking and documenting all activities
  • Licensure in the Mental Health field such as: LCSW, MFT, LCP, LCPC, PhD or an RN license
  • A Master's degree or RN with experience in mental health
  • A minimum of 6 months of experience with managed care
  • A minimum of 2 years of experience in behavioral health
  • A Valid Driver’s License along with proof of current insurancePreferred Qualifications
  • Quality improvement knowledge NCQA
  • JCAHO familiarity
95

Rn-prn-adult Specific Care-behavioral Health Resume Examples & Samples

  • Provides care for patient's with: Depression/Suicidal impulses, Mania, Delusions/Hallucinations, Paranoia, Anxiety, Aggressive/Assaultive Behavior, Chemical Dependency Issues/Detox, Personality Disorders, i.e. Borderline/Sociopathic, Eating Disorders, Dissociate Identity Disorder/PTSD, Dementia/Alzheimer's, and medical