The NCQA/Compliance Coordinator-Behavioral Health shall be responsible for developing, implementing, and evaluating member and provider interventions in support of behavioral health management and quality improvement programs. The NCQA/compliance coordinator - behavioral health will ensure that HEDIS interventions and relevant NCQA quality improvement initiatives are effectively documented and operationalized. The NCQA/compliance coordinator is responsible for reporting and presenting comprehensive analysis to relevant stakeholders. This role will also facilitate the achievement of quality metrics for behavioral health populations with special needs through Health Home assignment and serving as the clinical liaison to the Health Homes.
Qualified health professional with an active, unrestricted New York State licensure required.
Bachelors of Science degree or equivalent required; Advanced degree preferred. Appropriate certification required; examples to include but not limited to the following, (RN, LPN, BSW, MSW, LMHC, CRC, CCM).
Minimum five (5) years clinical experience in a behavioral health setting preferred.
Experience in program development required – behavioral health program development experience preferred.
Experience in quality improvement identification and implementation.
Excellent written, verbal and interpersonal communication skills.
Solid PC skills, including Word, Excel, PowerPoint required.
Maintains confidentiality and uses only the minimum amount of protected health information (PHI) necessary to accomplish job related responsibilities. Understanding of HIPAA regulations.
Other duties as needed. Every associate is given a job description upon hire outlining the qualifications, duties, and pay grade of the position. Independent Health reserves the right to change job descriptions as necessary.
Experience in a managed care setting accredited by NCQA or other regulatory body with specific duties related to compliance preferred.
Demonstrated ability to review and interpret regulatory requirements, implement new procedures to comply with regulatory bodies
Solid organizational skills, with the ability to manage multiple tasks.
Ability to travel locally and out of the area, if necessary. Any Independent Health associate who uses a motor vehicle in the course of their duties representing Independent Health must be compliant with New York State Motor Vehicle laws and must follow the Policy that pertains to Driver’s License Requirements as a condition of employment.
Independent Health is an equal opportunity employer.
Independent Health - 24 months ago