Senior Quality Improvement Specialist, Behavioral Health

What We Provide

• Referral bonus opportunities

• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays

• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability

• Employer-matched retirement saving funds

• Personal and financial wellness programs 

• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care  

• Generous tuition reimbursement for qualifying degrees

• Opportunities for professional growth and career advancement 

• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities  

What You Will Do

• Supports Behavioral Health (BH) provider engagement efforts, with a focus on leveraging performance data to support provider improvement and enhance value delivered to VNS Health members.
• Drives year over year BH provider performance improvement through targeted education, coaching, and data.
• Establishes strong relationships with BH providers and supports measurable improvements in clinical quality, access, and member outcomes.
• Collaborate with internal clinical, quality, and network teams to advance HEDIS performance and achieve clinical, quality, and network improvement goals.
• Creates and maintains linkages between providers of all levels of care, as well as other community-based services and resources to improve transitions of care and continuity of services.
• Partners with network providers and Carelon stakeholders to operationalize innovative programs, tools, and online resources to improve BH quality outcomes.
• Identifies opportunities for new or expanded BH initiatives, pilot programs, and supports planning, implementation, and evaluation of their impact.
• Participates in special projects and performs other duties as assigned.

Licenses and Certifications:

• License and current registration to practice as a LCSW, LMFT, LMHC, LPC, or Licensed Psychologist in New York State or New Jersey required

Education:

• Master's Degree in Social Work or other Behavioral Health field required

Work Experience:

• Minimum of five years experience in a health plan or health care setting required
• Minimum of four years quality improvement experience required
• Minimum of two year experience, quality management, practice improvement and compliance required
• Demonstrated experience leading or facilitating cross-functional quality initiatives required
• Excellent oral, written and interpersonal communication skills, including group facilitation skills required
• Knowledge of basic Performance Improvement tools and methodologies (e.g., PDSA, LEAN, Six Sigma). preferred
• Experience applying data analysis to clinical and operational improvement strongly desired. preferred