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PROVIDER RELATIONS MANAGER BCM

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Date: Mar 28, 2019

Location: YONKERS, NY, US

Company: Montefiore Medical Center

Provider Relations Manager Behavioral Health

Requires knowledge of the health care or behavioral health field. The provider relations manager is responsible for management of the behavioral health network, oversight, and resource development for multiple behavioral care management programs in collaboration with directors and associate directors and clinical managers and multiple internal and external departments. Acts as primary contact for contracted behavioral health individual and facility providers as well as health plans. Develops understanding of our Behavioral Care Management program, policies and procedures with particular focus on the expanded Medicaid products and HARP programs.   Develops expertise of Behavioral Health regulatory policies and keep on top of rapidly changing NY State guidelines and processes, e.g. HARP, OASAS Residential Redesign as that rolls out, Children’s Health Transformation, and helping UBA, CMO, and providers stay abreast of what is needed to know to work effectively. Develops new relationships with additional providers of traditional and non-traditional services to expand to extent possible UBA’s BH network. Helps ensure to maximum extent possible that BH providers are attending to medical conditions of their patients and coordinating with medical professionals involved, or getting medical providers involved as needed. Ensures accurate information and effective flow of data between UBA, Contracting, Provider Information, MIS and health plans  regarding network status of providers as well as other plan-provider issues. Monitors and educates Providers about changing regulatory and health plan guidelines. Educates behavioral health providers about HARP and HCBS services, how to get members assessed for those services, etc. Helps to expand provider awareness of multiple program expanded services and expanded advantages for new patient services. Identifies and brings provider concerns/issues to UBA and CMO leadership for resolution when needed.

 

Department: CMO Bargaining Unit: Non Union Campus: YONKERS  Employment Status: Regular Full-Time Address: 3 Executive Boulevard, Yonkers
Shift: Day Scheduled Hours: 8:30 AM-5 PM Req ID: 97973 

 

Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law. 

 

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Nearest Major Market: Yonkers
Nearest Secondary Market: New York City

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