Remote Behavioral Health Specialist

Looking for a fully remote HEDIS role this HEDIS season? Apply now!

Job Description

Position Purpose: Supervise and facilitate successful interventions to meet behavioral health HEDIS and Pay for Performance measures. Partner with health plans and regional clinical leadership to identify and implement interventions to increase HEDIS rates in behavioral health measures.

Develop and implement innovative strategies in collaboration with clinical staff to improve compliance with key behavioral health HEDIS metrics and Pay for Performance (P4P) Measures. Prepare and present financial impact and return on investment on initiatives requiring additional funding or resources. Act as a liaison with quality improvement, health plan medical management, and other departments regarding current and planned interventions. Collect input on how to impact these outcomes and provide feedback to stakeholders on outcomes. Monitor the effectiveness of new and existing P4P and HEDIS initiatives. Ensure appropriate knowledge/education and interventions are conducted for members falling into these measures. Analyze data to address trends or potential quality and clinical improvement opportunities based on best practices and feedback from involved stakeholders.

Hard Skills

• Knowledge of key behavioral or physical health related HEDIS & performance measures
• Experience in implementing new interventions to affect HEDIS rates
• Data analysis to address trends or potential quality and clinical improvement opportunities

Soft Skills

• Supervisory or lead experience
• Ability to collaborate with clinical staff and other departments
• Strong communication skills for presenting financial impacts and feedback

Job Type

This is a contract position with a duration of 21 Weekly.

Work Site

This is a fully remote position.

Work Environment

This position requires collaboration with health plans, regional clinical leadership, and other departments. The role involves monitoring and analyzing data to improve compliance with HEDIS and Pay for Performance measures

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $38 - $42