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VP CLINICAL CRL & CNS in Remote at Beacon Health Options

Date Posted: 11/16/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a Vice President Clinical CNS & CRL to join our growing team.  The VP Clinical CNS & CRL will have responsibility for the executive oversight and strategic direction of the 24/7 Central Night service and clinical referral line call center operations. Through effective leadership, planning, process management, and information analysis, this individual will be responsible to build a customer-focused environment. Expert level Operational and Clinical Management skills coupled with innovation, gaining and retention of knowledge and capabilities deliver ever-improving value to our customers, both internal and external. 

Position Responsibilities:

  • Ensures that all referral line and central night service calls are serviced within the performance thresholds to meet all contractual requirements.
  • Provides oversight of call center to ensure quality, productivity and telephone standardsare met. Collaborates with Clinical Directors on all clinical related matters.
  • Through effective communication, planning and partnership develop cohesive working relationship with Clinical Directors and Service Center Vice Presidents to maintain the highest clinical standards while meeting client telephone performance and clinical review turnaround time expectations.
  • Ensure through process management, key processes are examined for quality, timeliness, efficient and are cost effective.
  • Leverage telephony, call flows and technology for first call resolution.
  • Ensures operational performance and budgetary targets are effectively monitored and achieved
  • Ensures member inquiries are handled in accordance with performance standards.
  • Manages the daily operations including EAP, MHSA, and overflow, as well as system tracking and performance.
  • Builds and maintains excellent client relationships and partnerships with account services and Service Center VP’s supported by CRL and CNS.
  • In joint collaboration with quality management, call center and clinical directors, identifies training needs and co-ordinates training programs
  • Review for medical appropriateness psychiatric/substance abuse cases utilizing professional knowledge to applyBeacon criteria and render certification decisions that are within the scope of practice that is relevant to the clinical areas under review
  • Develop processes that support staff working ondifferent/ multiple systems supporting the business needs of Beacon
  • Involved in and understanding of regulatory and accreditation requirements to support NCQA/URAC accreditation
  • Involved in all implementations as required assuring staffing, training are in place to meet all performance standards
  • Work with finance to develop a thorough underwriting model to support current and new clients
  • Develop allocation metrics to quantify resources needed for each account and service.
  • Develop and implement monthly/quarterly and annual reports for each account and region to demonstrate performance.
  • Performs other activities/tasks as deemed appropriate and dictated by business needs.

Position Requirements:

Education: A minimum of a Bachelor Level Nursing or Licensed PhD, LCSW, LCSW/LMSW with experience in behavioral health/substance abuse.

Licenses: Current, valid and unrestricted license in a State or territory of the United States in a mental health field (RN, Ph.D., LCSW/LMSW, MHC, LPC, etc.).

Relevant Work Experience:  5-7 years management experience in a healthcare managed care setting, Min of 3-5 years, call center environment (24/7 environment required). Additionally, at least five (5) years of experience in psychiatric or substance abuse treatment setting that included inpatient, partial, and /or outpatient care is required. Management experience in an organization serving publicly funded clients preferred.

Knowledge, Skills & Abilities:

  • Strong leadership/team building ability required.
  • Computer literate, experience with management information systems
  • Strong customer service orientation, organizational skills, and time management skills needed.
  • Strong management skills covering a 24/7 Call Center Environment
  • Experience with managing and leveraging telephony systems and call flows to achieve optimal performance
  • Experience and knowledge of EAP service delivery

TO APPLY

Click below on “Apply for this Position” to create a profile and apply for the position

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

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