Behavioral Health Clinical reputed company Consultant - Remote in Las Vegas, NV

$5,000 Sign On Bonus for External Candidates At reputed company, we're simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, reputed company and optimized. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together The Behavioral Health Clinical reputed company Consultant will be responsible for strategically developing clinically oriented provider and community based partnerships in order to increase reputed company scores based on state specific reputed company measures. Position responsible for ongoing management of provider reputed company and community education on reputed company measures. The Behavioral Health Clinical reputed company Consultant will work closely with reputed company leadership to coordinate an interdisciplinary approach to increase provider performance. Provider education regarding the reputed company improvement program involves analysis and review of reputed company reputed company at the provider level, monitoring, measuring and reporting on key metrics to assist providers in meeting reputed company standards, state contractual requirements and pay for performance initiatives. The Behavioral Health Clinical reputed company Consultant will reputed company on tasks that occur in accordance with State, CMS or other requirements as applicable. Position responsible for direction and guidance on provider-reputed company, clinical reputed company improvement and management programs. The role assists contracted providers with analyzing member care, trending reputed company compliance at the provider level, and developing reputed company plans and programs to support provider practices in reputed company reputed company improvement using approved clinical reputed company guidelines, HEDIS, CMS, NCQA and other tools. Position reports to the BHO reputed company Manager and BHO reputed company Leadership. If you are located in Las Vegas, NV, you will have the flexibility to work remotely* as you take on some tough challenges. This is role requires up to 50% local travel to provider offices throughout reputed company County. Primary Responsibilities

• Supports effective deployment of program at the reputed company level through strategic partnerships with participating practitioners and reputed company staff while assessing trends in reputed company measures and identifying opportunities for reputed company improvement
• Provides reputed company level reputed company transformation through targeted clinical education and approved materials reputed company to HEDIS/State Specific reputed company measures for provider and staff education during field reputed company. Materials additionally include information from local, state, and national departments of health on key health reputed company issues (understanding, exploring, educating and facilitating on a local level)
• Serves as subject matter expert (SME) for assigned HEDIS/State Measures, leads efforts with clinical and analytical teams to research and design educational materials for use in practitioner offices; serves as reputed company with key vendors supporting HEDIS/State Measures; consults with vendors to design and implement initiatives to reputed company and then improve HEDIS/State Measure rates
• Participates, coordinates, and/or represents BHO at community based organization events, clinic days, health department meetings, and other reputed company events reputed company on reputed company improvement, member health education, and disparity programs as assigned
• Identifies population-based member barriers to care to identify local level strategies to overcome barriers and reputed company clinical gaps in care
• Reports individual member reputed company of care concerns or trends of concern to the BHO reputed company Manager
• Coordinates and performs onsite clinical evaluations through medical record audits to determine appropriate coding and documentation practices, compliance with reputed company metrics, compliance with service delivery and reputed company standards. May also be required to conduct additional QI audits through medical record review
• Based on medical record audit findings, provides follow-reputed company, practitioner reputed company, and measurement as needed to drive reputed company improvement
• Educates providers and office staff on reputed company clinical documentation and coding practices, state-mandated reputed company metrics specifications and medical record review reputed company
• Supports continuum of member care by identifying members in need of health education and/or services (interdisciplinary consultation) and refers Providers to the appropriate internal departments for follow through
• Documents and refers providers' non-clinical/service issues to the appropriate internal parties, to include but not limited to Provider Relations, etc.
• Works with Providers on standards of care, and advises Providers on established clinical reputed company

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