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CDPHP Manager, Behavioral Health Care Management in Albany, New York

CDPHP and its family of companies are mission-driven organizations that support the health and well-being of our customers and the communities we are proud to serve. CDPHP was founded in Albany in 1984 as a physician-guided not-for-profit, and currently offers health plans in 29 counties in New York state. The company values integrity, diversity, and innovation, and its corporate culture supports those values wholeheartedly. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.

The Manager, Behavioral Health (BH) Care Management is responsible for the development and execution of behavioral health and HARP care management processes to achieve the Quadruple Aim. The Manager will provide oversight for processes to address Behavioral Health/HARP Case Management. They work collaboratively with facility and outpatient provider personnel to ensure that CDPHP Behavioral Health/HARP members are moving along the continuum of care in a timely manner, monitoring for potential quality of care issues and identifying and coordinating care to ensure treatment is addressing the behavioral and healthcare goals. The Manager actively monitors care management data to identify potential over /or underutilization of services, and help to ensure coordination of care and communication with County and State agencies as well as CMS and NCQA regulatory requirements.

QUALIFICATIONS:

  • Master’s degree and NYS licensure in behavioral health discipline: LMHC, LMSW, or LCSW required.

  • Minimum (5) years of experience in a managed care setting, or behavioral health clinical setting, including at least two (2) years of managed care experience (preferably Medicaid managed care) required.

  • Working knowledge of regulatory guidelines related to CDPHP Medicaid utilization and case-management to include DOH, OMH, OASA, CMS, DOI and NCQA required.

  • Minimum two (2) years of prior supervisory/team lead experience required.

  • Knowledge of claims management systems is preferred.

  • Experience with Microsoft Office, including Word, Excel, Outlook and PowerPoint is required.

  • Demonstrated leadership, coaching and staff development skills.

  • Demonstrated ability to plan, lead, organize and implement and carry out comprehensive care management activities across the continuum of care.

  • Demonstrated expertise in integrating care management initiatives.

  • Demonstrated ability to prepare accurate, concise, statistical management reports on care management interventions and quality measures

  • Excellent verbal and written communication skills.

  • Demonstrated ability to pro-actively identify problems, as well as recommend and/or implement effective solutions.

  • Demonstrated ability to provide excellent customer service and develop relationships both internally and externally.

  • Flexibility to adapt to a changing and fast-paced environment.

  • Ability to work with and maintain confidential information.

    As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices on the basis of race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.

    CDPHP and its family of companies include subsidiaries Acuitas Health LLC, Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRX Services, LLC.

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