Behavioral Health Clinical Program Manager

Company: Neighborhood Health Plan of Rhode Island
Location: Smithfield
Posted on: April 19, 2025

Job Description:

Job DetailsJob Location Smithfield, RI - Smithfield, RIPosition Type Full TimeEducation Level Bachelors Degree -Travel Percentage OccasionalJob Shift DaytimeJob Category ManagementDescription The Behavioral Health (BH) Clinical Program Manager is responsible for leading and supporting the collection, analysis, and reporting of data and the development of intervention strategies in support of advancing the organization's BH strategy. This position supports program development, monitoring, and evaluation of programs to drive evidence-based decision making in behavioral health. The BH Clinical Program Manager provides regular reporting to committees and leadership to highlight progress and ensure alignment with company initiatives and goals. Works both independently and collaboratively, compiling and analyzing complex data and information to provide meaningful results, identify success factors and improvement opportunities, suggest potential solutions, and help internal customers set strategic directions. The BH Clinical Program Manager should bring intellectual curiosity, proven data analytics skills, and problem-solving to deepen insights into the factors that drive health care quality, costs, and equity.

Duties and Responsibilities

Responsibilities include, but are not limited to the following:

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• Analyze available industry data, trends, and best practices to leverage for organization Behavioral Health strategy development
  
• Gather and analyze data to support decision-making and program measurement. Evaluates trends to identify and implement changes in process and policy to improve financial and quality outcomes
  
• Develop data tracking mechanisms and reports for multiple Behavioral Health deliverables
  
• Facilitate meetings, develops and delivers progress reports, proposals, requirements, presentations and other documentation
  
• Support the department's leadership team for operational work as well as larger scope activities, including, but not limited to, writing department annual reports and ad hoc requests, develops and maintains department dashboards, and performs department audits
  
• Lead the design, implementation and evaluation of clinical programs to support clinical strategy, population health, health equity, and quality efforts
  
• Engage in continuous quality improvement efforts to support the monitoring, evaluation and improvement of behavioral health initiatives. Recommend opportunities and/or action plans for improved performance based on business need
  
• Develop written reports inclusive of qualitative and quantitative analysis outlining conclusions and recommendations for improvement
  
• Identify and communicate risk areas and barriers that could inhibit the organization's ability to achieve BH utilization targets and clinical program goals
  
  
  
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  • Other duties as assigned
    
  • Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhood's Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents.
    
    Qualifications
    
    Qualifications
    
    Required:
    
    
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    • Bachelor's degree in public health or behavioral health related field, or equivalent combination of education and relevant work experience, in lieu of a degree
      
    • Five (5) + years' experience working in healthcare, with substantial knowledge of the behavioral health system and provider environment
      
    • Experience working with health care analytics, regulatory requirements, and project management
      
    • Experience working with statistical analysis of complex health care data sets, including health care claims and health outcomes data, to support improvement activities
      
    • Strong analytical, attention to detail, and critical thinking skills
      
    • Demonstrated ability to develop written reports inclusive of qualitative and quantitative analysis outlining conclusions and recommendations for improvement
      
    • Excellent interpersonal skills, including the ability to work across the organization and externally and to interact, influence and negotiate effectively at all levels of management
      
    • Ability to work independently with minimal supervision
      
    • Effective communication skills, both verbal and written
      
    • Outstanding time management and organizational skills
      
    • Highly proficient in Microsoft Excel, PowerPoint and Word
      
      
      Preferred:
      
      
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      • Master's degree in public health or behavioral health field (social work, counseling)
        
      • Experience working in a managed care environment with focus on health care analytics and quality improvement requirements
        
      • Two (2) + years' experience in the analysis and interpretation of health care data, such as health care claims data, public health surveillance data, health survey data and clinical data abstracted from medical records
        
      • Knowledge of medical coding systems used for diagnoses, procedures, pharmaceuticals and clinical laboratory data
        
        
        Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
        

Keywords: Neighborhood Health Plan of Rhode Island, Plymouth , Behavioral Health Clinical Program Manager, Healthcare , Smithfield, Massachusetts