Behavioral Health Quality Manager-Specialist

POSITION SUMMARY:

The Behavioral Health Quality Manager-Specialist will be responsible for patient outreach, patient care, and process improvement for initiatives to drive improvement for Behavioral Health Quality metrics within the Massachusetts Medicaid (MassHealth) Accountable Care Organization (ACO) and other value-based contracts. This position works within the Boston Medical Center Health System (BMCHS) Population Health Services (PHS) Behavioral Health team, collaborating closely with the Quality team, and will be responsible for participating in the design and leading the performance improvement initiatives for Behavioral Health Quality, including engaging directly with patients with mental health and substance use disorders who are in scope for the relevant quality metrics. Excellent patient engagement will be a critical skill for the individual in this role.

The role will involve direct patient outreach, clinical care, system navigation, and service coordination to address several of the key MassHealth ACO Quality metrics. In addition, the role will participate in working with BMCHS’s partner organizations across Massachusetts to support their local site strategy development. Key requirements for this role include excellent patient engagement, strong communication with other healthcare providers and practice leaders, and the ability to work independently and collaboratively. Clinical experience working with populations impacted by severe mental health and substance use disorders, including in acute episodes of illness, is required, as well as knowledge of relevant treatment systems. This position supports patients across Massachusetts and may be performed up to 100% remotely, although periodic in-person availability for collaboration with the BMCHS team is preferred. This role will also support the PHS Behavioral Health team in broader system-wide Behavioral Health strategy. This role is an ideal and unique opportunity for individuals seeking greater experience with system-level population health management. The candidate must be an independently licensed behavioral health clinician in Massachusetts (e.g., LICSW, LMHC, LMFT, PsyD, PhD, MD, DO, Psychiatric NP).

Position: Behavioral Health Quality Manager-Specialist

Department: Population Health

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Perform outreach and care for Quality initiatives for patients following inpatient psychiatric hospitalization and emergency department visits for behavioral health conditions. This includes:

  • Outreach to patients and track response

  • Provide telehealth visits

  • Perform behavioral health assessment, including risk assessment

  • Conduct complete, accurate, and timely documentation in electronic health record

  • Perform coordination of care with patient’s longitudinal outpatient providers

  • As needed, connect patients to appropriate outpatient behavioral health care providers and medical providers

• Participate with Population Health Medical Directors and Behavioral Health Directors in the design and process improvement of Quality initiatives

• Continually assess and improve clinical outreach, engagement, and care provision model

• Maintain up-to-date working knowledge of behavioral health resources and referral pathways

• Work with PHS Behavioral Health team to identify approaches to expanding and disseminating post-acute behavioral health care model, including in partnership with BMCHS partner organizations

• Participate in all training requirements and opportunities as designated by PHS Behavioral Health team

• Participate with PHS Behavioral Health team on primary care site guidance around Behavioral Health quality objectives

• Participate with PHS Behavioral Health team, Quality team, and Analytics team on optimizing data pipelines for Behavioral Health quality

• Maintain HIPAA standards and confidentiality of protected health information.

• Adhere to departmental/organizational policies and procedures.

• Complete other duties as specified by the Population Health Services Behavioral Health team

Must adhere to all of BMC’s RESPECT behavioral standards.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job.  The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

EDUCATION:

• Master’s Degree or Doctoral Degree in clinical behavioral health field (e.g., MSW, Master’s of Mental Health Counseling, PsyD or PhD in clinical psychology, MD, DO, MSN).

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

• Independent licensure (e.g., Massachusetts LICSW, LMHC, LMFT, clinical psychologist, psychiatrist, or psychiatric NP).

EXPERIENCE:

• At least 2-4 years of clinical experience with individuals with severe mental health and substance use disorders

• Experience working in systems that serve complex and vulnerable populations

KNOWLEDGE AND SKILLS:

• Strong behavioral health evaluation skills including risk assessment and common diagnoses

• Strong understanding and familiarity with levels of care and how to navigate behavioral health system

• Extensive knowledge of healthcare systems and relevant community resources

• Sensitivity to ethnic, cultural, gender, and sexual orientation diversity, values, beliefs, and behaviors

• Experience with client centered practices including harm reduction approach and motivational interviewing

• Must display the use of appropriate independent judgment to determine appropriate course of action in resolving problems and in emergencies related to behavioral health needs of patients

• Ability to express self adequately in written and oral communication and to communicate effectively in an interdisciplinary, culturally diverse setting with clients, families, staff and agencies

• Excellent interpersonal skills and ability to work collaboratively

• Self-management skills, including ability to prioritize and organize

• Able to maintain professional boundaries

• Ability to work with diverse, safety-net population

• Skilled at working alongside difficult to engage patients—build rapport, trust

• Ability to work in a fast paced environment, inclusive of organizational skills, time management skills, critical thinking, and problem solving abilities

• Computer competency, inclusive of the ability to access and enter data through the electronic medical record system and manage personal email system

• Bilingual or multi-lingual skills (beyond that of English) appropriate to the patient population serviced, is preferred

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Equal Opportunity Employer/Disabled/Veterans