Quality Management Clinical Outreach Specialist

Job Ref: TE0055

Category: Quality Assurance

Department: QUALITY ASSURANCE

Location: 50 Water Street, 7th Floor,
New York,
NY 10004

Job Type: Regular

Employment Type: Full-Time

Work Arrangement: Hybrid

Salary Range: $79,000.00 - $89,000.00

The OS is responsible for telephonically outreaching members who were recently discharged from Inpatient Care, Emergency Rooms and Outpatient Programs with a principal Behavioral Health diagnosis. The OS will be conducting a bridge visit where they assess the member's current state, review their discharge plan and assist in connecting them to appropriate aftercare services. The OS will also work collaboratively with other teams, such as Behavioral Health Case Management, to ensure the needs of our members are met.

To succeed in the role, candidates must be:

• Self-motivated and able to work in a fast-paced, dynamic work environment
• Possess strong attention to detail and technical abilities
• Organized and able to meet deadlines
• Demonstrate strong communication skills

Scope of Role & Responsabilities:

• Assists members in accessing post-discharge aftercare related appointments/rescheduling new appointments.
• Interfaces with members and Behavioral Health or Medical Case Management staff to coordinate aftercare activities.
• Delivers crisis and emotional support when needed during telephonic outreaches. Ability to de-escalate crisis/utilize crisis intervention techniques and motivational interviewing before bridging to proper crisis services.
• Meets the daily expected call volume and number of bridge visits. Self-monitors productivity and accepts supervision towards a high level of member care.
• Maintains accurate and complete documentation of required information in compliance with risk management and regulatory requirements.
• Shares observations and provides feedback regarding workflow to ensure continuous quality improvement.
• Performs other departmental duties and participates in special/ad-hoc projects as assigned.

Required Education, Training & Professional Experience:

• Master's Degree required.
• Minimum 3 years of Behavioral Health (Serious Mental Illness & Substance Use Disorder) experience in managed care setting.
• Minimum of 3 years' post licensing experience working directly with consumers towards their recovery.
• Understanding of Medication Assisted Treatment process.
• Pharmacy, Psyckes, E-Paces, HCS (UAS) MAPP knowledge.
• Working knowledge of current DSM Manual and understanding of Behavioral Health diagnosis. Knowledge HEDIS/QARR strongly preferred.
• Knowledge of quality improvement methodologies, i.e., PDSA, Six Sigma.
• Strong technical skills (Microsoft Office, specifically MS Excel and MS Access; ability to navigate multiple computer programs and applications).
• Bilingual (English/Spanish) strongly preferred.

Licensure and/or Certifcation Required:

Valid New York State license and current registration to practice as Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), or Licensed Mental Health Counselor (LMHC).

Professional Competencies:

• Integrity and Trust.
• Customer Focus.
• Demonstrated ability to communicate effectively, problem solve and work effectively with people.
• Clear and concise written/oral communications.
• Exceptional time management and organizational skills.
• Ability to function in a fast-paced, dynamic work environment.
• Strong interpersonal skills, the ability to remain calm and poised with challenging situations.
• Self-starter who is able to perform tasks at a high level with minimal supervision.
• Ability to work evenings and weekends as needed to meet department goals.

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