Main responsibility is supporting the Regional Behavioral Health Authority (RBHA) line of business as part of the System of Care team, as it pertains to Arizona Medicaid members with a Serious Mental Illness (SMI) diagnosis in the Central GSA. Also, serves as subject matter expert and liaison for SMI members across the other Mercy Care plans. The core responsibilities include the oversight of the SMI Behavior Health and Integrated Health homes and providing the necessary support for those clinics in fulfilling their contractual responsibilities of services and care for member. Collaboration and coordination are essential with this position along with solid data management and analytical skills. Strong organization and communication skills are required along with the ability to manage multiple time sensitive projects.
• Oversee SMI Behavior Health/Integrated Health Homes, providing technical assistance of responsibilities as outlined by Provider Manual, Operations Manual, AHCCCS Covered Services Guide
• Primary point of contact and oversee SMI Outpatient Providers for the central RBHA GSA
• Representative of SMI Services team in committees, provider meetings, external and internal stakeholder meetings
• Management of Provider deliverables, provider validation audits, analyzing and trending data
• Management of internal reports to leadership and external stakeholders (ex. Regulator)
• Processing member service requests for NT19 state only funding
• Collaboration with Integrated Care Management, Utilization Management, Operations and Medical Management
• Community Forum presentations
• Health-E Arizona (HEA) Deliverable management- tracking of self-reported data as it relates to member eligibility checks and screenings
• Member concerns and follow up
• Collaboration with Courts and Crisis teams, Housing, Employment, CSOC, and DDD Liaison
At least 3 years experience, minimum, working with the SMI population, behavioral health and/or within the Arizona Medicaid system. Basic knowledge of Microsoft Office (Word, Excel and Power Point).
Three years working in the non-profit field. Experience working in outpatient behavioral health/integrated health setting. Understanding/knowledge of health equity and health disparities.
Masters degree in behavioral health (Social Work, Counseling, Psychology) and two years experience. Masters degree in other related field and three years experience. Bachelors degree in behavioral health or related field and four years experience. Or five years experience working with SMI population and Arizona Medicaid System.
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
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