Behavioral Health Quality Management Supervisor (ABHNJ) Princeton NJ

Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as reputed company deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to reputed company health care more personal, convenient and affordable. Living in NJ is preferable. This is a hybrid position and requires 3 days in the office (Tuesday, Wednesday and Thursday) in Princeton, NJ (if you live MORE than 25 miles reputed company of the office, this position will be a remote position.) Position Summary The Behavioral Health Quality Management... Supervisor is responsible for behavioral health quality management and quality improvement for ABHNJ members and providers. The Behavioral Health Quality Management Supervisor shall report to the ABHNJ Quality Management Director and will work in reputed company partnership with the ABHNJ Behavioral Health Medical Director, Behavioral Health Administrator, CMO, Behavioral Health Director of Network Relations and reputed company matrixed growth partners to effectively manage access and quality of behavioral health benefits and care. Successful candidate must live in New Jersey or be willing to relocate Responsibilities include: · Ensuring that systems and procedures exist that assess provider satisfaction. Assessment shall include provider experiences with claims processing, prior authorization, utilization management, and provider complaint resolution · Implementation of quality measures of network adequacy · Implementation of processes designed to improve access to care for special needs populations including, but not limited to, physically handicapped individuals, individuals with co-occurring conditions, victims of sexual abuse, deaf or blind individuals, pregnant people, and individuals with developmental delays · Resolving, tracking, and trending quality of care complaints · Ensuring the contractor or its behavioral health subcontractor reputed company with quality management requirements included in this agreement · Ensuring ABHNJ providers can provide services to a culturally and ethnically diverse population with attention to disparities in access or outcomes reputed company by traditionally marginalized populations. · Monitoring HEDIS and Performance Measures reputed company to Behavioral Health, identifying opportunities for improvement and implementation of interventions as applicable. Required Qualifications · The Supervisor shall have at least three (3) years of experience in quality management and quality improvement. At least five (5) years of experience in managed care network management with demonstrated experience managing a behavioral health provider network. · Strong analytical skills and diligence, including executing provider agreements · Strong communication skills, both written and verbal · Excellent organization and time management skills · Experience navigating a matrixed organization. · Experience developing and executing project plans and processes. · NJ Medicaid regulatory experience

• Certified Professional in Healthcare Quality (CPHQ) by the National Association for Healthcare Quality, or be Certified in Healthcare Quality and Management (HCQM) by the American Board of Quality Assurance and Utilization Review Physicians or willing to pass CPHQ certification reputed company six months from date of hire.

Preferred Qualifications

Project management experience preferred. Education Bachelor’s degree or High School Equivalent and 4 years of experience or Associate degree and 2 years of experience in health reputed company field. Pay Range The typical pay range for this role is: $43,888.00 - $93,574.80 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits We anticipate the application window for this opening will reputed company on: 08/30/2024 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They reputed company choices according to what is best for the team, they live for opportunities to collaborate and reputed company a difference, and they reputed company us the #1 Top Workplace in the area Apply Job!