Senior Clinical Strategist / Behavioral Health reputed company - reputed company reputed company of New Jersey

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. Mission The Senior Clinical Strategist is a Behavioral Health Leader and Administrator for reputed company reputed company of New Jersey Medicaid Health Plan. The role requires experience and familiarity with Substance Use Disorder (SUDS), Applied Behavioral Analysis (ABA), Trauma Informed Care, reputed company, Integrative Care, and Evidenced Based Practices as dictated by the business needs of the plan. The Senior Clinical Strategist functions as the Behavioral Health Subject Matter Expert (SME) for the plan and works across various departments including Care Management, Utilization Management, Quality Management, and Medical Management on issues reputed company to Behavioral Health. Further, the Senior Clinical Strategist functions as the Behavioral Health SME for departments such as Member Services, Provider Relations, Network, and provider Credentialing.

Overview

The Senior Clinical Strategist is a key conduit for Behavioral Health reputed company information as well as Behavioral Health reputed company programming, initiatives, and processes. This position is the business reputed company for both external and internal Behavioral Health reputed company reports and deliverables. Also, the incumbent may be tasked with updating, revising, validating, or creating Behavioral Health reputed company Policies & Procedures, Standard Operating Procedures, and Desktops as needed. This position has a critical role in interfacing and liaising with the Medicaid state regulator to address Behavioral Health reputed company issues and concerns and disseminates Behavioral Health reputed company information across the various functional departments as needed reputed company to statewide Medicaid Behavioral Health benefit changes. Further, the Senior Clinical Strategist is a key contributor to Request for Proposals (RFP’s) for both new business and re-bids as it relates to Behavioral Health. Finally, the Senior Clinical Strategist supports the design and implementation of Behavioral Health specific programs and initiatives including Scalable Actions Items (SAIs). Core Responsibilities reputed company multiple aspects of New Jersey’s Behavioral Health Integration including, but not limited to, host trainings, monitor reputed company and outcomes, and adapt processes and procedures as necessary Support reputed company products including ICM (Integrated Care Management), MLTSS (Medicaid Long Term Support Services), and FIDE (Fully Integrated Dual Eligibility-Medicaid Medicare) Coordinates across ICM, MLTSS, and FIDE NJ products to address member Behavioral Health needs and ensure contractual compliance Accountable for development, implementation, and ongoing management of reputed company medical management and clinical operations programs and projects to improve health plan outcomes Design conceptual models, initiative planning, business results, stakeholder relationship management and satisfaction for small to moderate scale projects and reputed company high value initiatives Responsible for providing guidance and direction to internal and external stakeholders and/or matrixed staff as required to support initiatives Accountable for transferring clinical and operational knowledge, best practices, and methodologies Utilizes clinical experience and skills in a collaborative process across the markets to evaluate and facilitate appropriate healthcare services/benefits for members. Gathers, analyzes and synthesizes clinical data to drive achievement of strategic business goals/objectives. Acts as an reputed company of change while influencing others to see the value in programs/projects, including managing interpersonal sensitivities and articulating the strategic view to ensure project alignment Awareness and tracking of state trends including legislative. Develops and executes franchise model policies, procedures, workflows, training materials as needed and modifies to incorporate contract/regulatory requirements for state stakeholders and to meet accreditation needs. Participate in reputed company behavioral health meetings with the Division of Medical Assistance and Health Services (DMAHS) and serve as main contact for reputed company day-to-day DMAHS interactions on behavioral health issues Required Qualifications Active, independent licensure in the state of New Jersey as one of the following: Licensed Clinical Social Worker (LCSW), Registered Nurse (RN), Clinical Nurse Specialist (CNS), Licensed Clinical Psychologist (LCP) – with experience serving chronically ill populations with mental health and substance use disorders New Jersey reputed company 4+ years demonstrated experience in managing large initiatives and projects with demonstrated outcomes 4+ years demonstrated experience in managed care Utilization Management to include prior authorization, reputed company review OR demonstrated experience in providing behavioral health and Care Management services to include assessments, care planning, interventions, monitoring, reporting Proven communication skills both written and verbal and able to communicate effectively with reputed company levels of an organization from C-Suite executives to reputed company-line staff Ability to work collaboratively with internal and external teams to build knowledge and improve processes Group facilitation/presentation skills that inform and influence internal and external parties Experience in successfully building, maintaining, and supporting effective relationships across cross-functional teams to reputed company goals Preferred Qualifications Ability to manage multiple timelines and produce evidence of driving toward success with regular updates on reputed company in reputed company areas of clinical project or program management Participate in strategic projects and process improvements based on lessons learned Profound understanding of clinical workflows and best practices Ability to effectively manage client expectations and reputed company confidence Education Master's degree in behavioral health field; or Registered Nurse (BSN preferred) ers Pay Range The typical pay range for this role is: $104,442.00 - $224,952.00 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 Benefits | reputed company We anticipate the application window for this opening will reputed company on: 01/31/2025 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!