Provider Clinical Liaison in Quincy, MA at Beacon Health Options

Date Posted: 3/19/2020

Job Snapshot

Job Description

Beacon is currently seeking a Provider Clinical Liaison to join our team based at our Quincy, MA office part time and home-based part time, with south shore travel required.

The Recovery, Education and Access to Community Health (REACH) Program, in partnership with Blue Cross Blue Shield of Massachusetts, is an innovative program that brings community based wraparound supports and services to high-risk commercial populations including members with Serious Mental Illness (SMI - adults) or Serious Emotional Disturbance (SED - children).  Members at clinical risk because of mental health, psychosocial and/or co-morbid problems are accepted into the REACH care management program. The program’s overall objectives are to promote resiliency, member self-management and create a pathway for recovery (i.e. Recover-Oriented System of Care, ROSC).  The direct provision of care management and wraparound supports will be delivered by care managers who are employed by community-based providers. 

Mission for Provider Clinical Liaison:

Oversee and train contracted community provider partners to increase our success in outreaching to and engaging members. As the primary liaison between Beacon and our providers, the Provider Clinical Liaison (PCL) oversees assigned community provider partners and ensures those providers meet the standards of the program and engages and works with members qualified for the program.

Outcomes:

  • Contribute to increasing overall Program Engagement to 20%
    • Increase the number of members contacted by Provider Partners assigned to 80%
    • Decrease the number of members marked declined by Provider Partners to under 50%
    • Review all declined members from Provider Partners that were marked unable to contact to determine reasons for inability to contact
    • Coordinate with REACH Outreach Coordinator to ensure successful transition of referrals are made.
  • Contribute to increasing Provider Partner Assessment Completion Rate to 80%
    • Ensure Provider Partners are aware of upcoming due dates and deadlines through regular weekly telephonic check-ins
    • Conduct re-training with all assigned Provider Partners on completing Assessment and Initial Care Plan in first meeting with members
  • Contribute to increasing Provider Partner Care Plan Completion Rate to 60%
    • Ensure Provider Partners are aware of upcoming due dates and deadlines through regular weekly telephonic check-ins
    • Conduct re-training with all assigned Provider Partners on completing Assessment and Initial Care Plan in first meeting with members
  • Contribute to increasing Provider Partner Re-Assessment Completion Rate to 25%
    • Ensure Provider Partners are aware of upcoming due dates and deadlines through regular weekly telephonic check-ins
    • During authorization meetings monthly, ensure all re-Assessments due to the month are completed and provide reminders to Provider Partners of those due the next month
    • Conduct re-training with all assigned Provider Partners on completing re-Assessment and updating Care Plans every 60 days
  • Contribute to increasing Provider Partner successful program completion and transition of members to 10%
    • Weekly telephonic and not less than quarterly live supervision of assigned Provider Partners to review cases clinically for follow-up, ongoing services, or transition
    • Ensure re-Assessments and updated Care Plans are completed timely and review for indicators of appropriateness of transition
    • Review of all Transition Forms to ensure providers are discharging them for the appropriate reason and reasonable efforts are conducted to engage members ongoing.

Other Responsibilities:

  • Conduct no less than weekly telephonic and no less than quarterly live meetings with assigned provider partners
  • Conduct no less than quarterly trainings on the REACH Program with hospitals assigned
  • Conduct semi-annual audits of provider partners assigned for auditing
  • Weekly Clinical Rounds presentations to management and plan partner for review of cases assigned.
  • No less than monthly live and monthly telephonic supervision with Manager of Care Management.
  • No less than monthly live team meeting to review key information regarding Beacon and the REACH Program.
  • Comply with all Beacon policy guidelines, external regulatory requirements and URAC/NCQA accreditation standards;
  • Assists with NCQA, URAC and other QI initiatives;
  • Other duties as assigned;

What you Contribute?

Education: Master’s degree or higher in a health related field and independent licensure as a behavioral health professional or BSN, licensure as a professional

Licensure: Current, valid and unrestricted licensure for practice required with proof on date of hire. Re-verification will take place no less than every 3 years.

Knowledge, Skills & Abilities:

  • Strong verbal and written communication skills.
  • Behavioral health experience and understanding of mental health and substance use services, managed care as well as current principles, procedures and knowledge domains of case management, Wraparound and Community-Based Services.
  • Good analytic skills and be comfortable working with metrics and data
  • Strong organizational skills
  • A high level of ability to work well under pressure and multi-task between multiple priority items
  • Works well in a fast paced environment as well as have excellent problem solving skills
  • Proficiency in Word, Excel needed and PowerPoint preferred.

What Makes Us Different?

  • Here, it’s not just a job – it’s an opportunity to change lives.
  • Our employees are learners, innovators and original
  • Our mission and values guide the way we treat our members, providers and each other.

What We Have to Offer:

  • Healthcare benefits available starting day 1!
  • Health & well-being incentives, such as gym membership reimbursement
  • 401K with company match to help reach your future financial goals
  • Generous PTO, because we know life happens outside of work
  • Tuition reimbursement so you can keep reaching your fullest potential

If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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