Behavioral Health Management Consultant (BHM)
8 - 10 years experience • Insurance
Skills : Degree in social work or psychology, behavioral health management, licensed social worker / licensed professional counselor.
Will be required to travel30-40%
Must have degree in social work or psychology.
Should be a licensed social worker or licensed prof counselor. We will look at similar licenses.
Must be experts in behavioral health.
Companies to look at: Optum, Magellan, Cigna, Beacon, etc.
As a Behavioral Health Management Consultant (BHM) in our growing specialty practice, you will support the lead consultant on client accounts participating in the development of behavioral health (BH) clinical management products and services. Activities address impact on members, plan operations, program integrity, pricing, quality, satisfaction, and outcomes. The BHM Consultant develops and tracks the appropriate metrics to monitor the quality and care cost impact of client programs. This may involve developing client strategy, interfacing directly with clients and developing vendor relationships. To fulfill this role, the BHM Consultant will:
•Participate as a member of the consulting team in developing overall health management client strategy
•Provide financial, contract and/or administrative analysis, and manage portions of projects, including reviewing the work of others.
•Analyze specific utilization problems, plan and implement solutions that directly influence quality of care
•Review internal compliance and client disclosure requirements, external vendor contracts, summary plan documents (SPD's) and employee communications to ensure alignment with client expectations and legal requirements
•Contribute to developing program offerings that are aimed at improving member experience and improving clinical outcomes
•Demonstrate subject matter expertise by contributing to the innovation of Company’s intellectual capital in support of employee emotional healthGather and interpret benchmarking, utilization or rate data from the vendors via a Request for Proposal (RFP) and interpret the meaning of the data and summarize the responses from the RFP in Excel or PowerPoint format for presentation to the client.
•Project management; coordinating status reporting; assembling project plans and providing input to budget and resource planning. Manage the quality and timeliness of client deliverables
•Participate in client calls and meetings as appropriate
•Delegate to and review project work of more junior colleagues
•Assist with the preparation and delivery of clear and concise client-friendly communications
•BA/BS, or advanced degree, psychology, social work or related field preferred
•At least seven years of industry related experience in behavioral health management/employer wellness field
•Knowledge of utilization management procedures supporting mental health and substance abuse programs; knowledge and experience in inpatient and/or outpatient setting a plus.
•Experience in providing patient assessments including level of risk, substance abuse and dependency, job performance issues and refer to appropriate level of care is a plus.
•Knowledge of DSM V or most current diagnostic edition.
•Knowledge of MS Office Tools (Excel, PowerPoint)
•Strong organization, time management and communication skills.