QM Clinical Outreach Specialist
Job Ref: 79343
Department: QUALITY MANAGEMENT
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $73,000.00
Salary Range: $73,000.00 - $83,000.00
Empower. Unite. Care.
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + Hospitals
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
The QM Clinical Outreach Specialist (OS) is expected to assist MetroPlusHealth members in their Behavioral Health recovery through direct contact to ensure that they are connected to clinical care and other community resources.
The OS is responsible for telephonically outreaching members who were recently discharged from Inpatient Care, Emergency Rooms and Outpatient Programs w/ a principal Behavioral Health diagnosis. The OS will be conducting a bridge visit where they assess the member’s current state, review their discharge plan and assist in connecting them to appropriate aftercare services. The OS will also work collaboratively with other teams, such as Behavioral Health Case Management, to ensure the needs of our members are met.
To succeed in the role, candidates must be:
- Self motivated and able to work in a fast-paced, dynamic work environment
- Possess strong attention to detail and technical abilities
- organized and able to meet deadlines
- demonstrate strong communication skills
- Assists members in accessing post-discharge aftercare related appointments/rescheduling new appointments.
- Interfaces with members and Behavioral Health or Medical Case Management staff to coordinate aftercare activities.
- Meets the daily expected call volume and number of bridge visits. Self-monitors productivity and accepts supervision towards a high level of member care.
- Maintains accurate and complete documentation of required information in compliance with risk management and regulatory requirements.
- Responsible for producing reports and presenting activity results to stakeholders.
- Performs other departmental duties and participates in special/ad-hoc projects as assigned.
- Collaborates with other MetroPlus teams to yield optimum outcomes.
- Delivers crisis and emotional support when needed during telephonic outreaches. Ability to de-escalate crisis/utilize crisis intervention techniques and motivational interviewing before bridging to proper crisis services.
- Shares observations and provides feedback regarding workflow to ensure continuous quality improvement.
- Bachelor’s Degree required.
- Minimum 3 years of Behavioral Health (Serious Mental Illness & Substance Use Disorder) experience in managed care setting.
- Minimum of 3 years post licensing experience working directly with consumers towards their recovery.
- Understanding of Medication Assisted Treatment process.
- Pharmacy, Psyckes, E-Paces, HCS (UAS) MAPP knowledge.
- Working knowledge of current DSM Manual and understanding of Behavioral Health diagnosis. Knowledge HEDIS/QARR strongly preferred.
- Knowledge of quality improvement methodologies, i.e., PDSA, Six Sigma.
- Ability to work evenings and weekends as needed to meet department goals.
- Bilingual (English/Spanish) strongly preferred.
- Current valid unrestricted NY State License in LCSW, LMSW, LMHC, or RN.
- Integrity and Trust
- Customer Focus
- Demonstrated ability to communicate effectively, problem solve and work effectively with people.
- Strong technical skills (Microsoft Office, specifically MS Excel and MS Access; ability to navigate multiple computer programs and applications)
- Clear and concise written/oral communications.
- Exceptional time management and organizational skills.
- Ability to function in a fast-paced, dynamic work environment.
- Strong interpersonal skills, the ability to remain calm and poised with challenging situations.
- Self-starter who is able to perform tasks at a high level with minimal supervision.
- Integrity and Trust
- Customer Focus
- Functional/Technical Skills
- Written/Oral Communications