Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds—tech people, numbers people, even people people—working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference—it’s time to make a healthy career move to MVP!

There are some positions at MVP where your work may require an onsite or community component. When working in an MVP office and/or in the community on behalf of MVP, you must be fully vaccinated against COVID-19, and have received the first booster dose within one month of eligibility.

This position is responsible for managing children with complex behavioral health needs as well as representing MVP as the government liaison attending external Medicaid line of business meetings. This position will provide oversight, leadership, and direction for the clinical interventions targeted to improve member and provider satisfaction, decrease cost waste, maximize quality, and improve clinical outcomes for the clinical care of the children’s behavioral health services. Must be a resident in NYS (no specific location in NY, this is remote work).

Responsibilities include but are not limited to:

• Participate in clinical oversight of the children’s services program.
• Collaborate, problem solve and suggest system improvements for the integration of mental health, addiction treatment services that is person and family centered, cost efficient and results in improved overall health for both children and adults during all external meetings.
• Foster partnerships with external stakeholders.
• Participate in Monthly meetings with the Health Homes and any Health Home subcommittees
• Actively shares minutes and feedback from external meetings with MVP management and works to identify solutions
• Development, implement and interpret policies and procedures specific to children’s services or can be expected to impact the heath and recovery of children. Ensure these are in compliance with regulatory and state compliance.
• Ensure strong collaboration between physical and behavioral health care.
• Ensure strong collaboration with, child-serving systems, including the education system, foster care system, Health Homes and other external agencies
• Ensure strong collaboration with internal departments regarding outcomes and targeted quality metric improvements on children’s services portions of the QM/UM Plan
• Administer children’s performance improvement activities
• Ensure execution of Plans of Care process
• Ensure regulatory turnaround times (TAT) are met
• Work closely with the Medicaid SBU to monitor program activities, ensure Health Home program compliance, identify improvements to ensure overall optimal program performance
• Support of Integrated Health model development across all activities.
• Development and support of initiatives that promote effective level of care transitions, maximize care access for members and promote engagement with health care team
• Planning, development, implementation and evaluation of processes and guidelines for

managing care across the health care continuum

• Oversee development and implementation of clinical programs that incorporate peer reviewed clinical guidelines and represent “best practices”.
• Ensure external regulatory and review agency requirements are met.
• Establish clear directions, set challenging, but achievable performance objectives, prepare performance reviews and action plans for direct reports.
• Responsible for orientation, hiring, ongoing coaching and mentoring of direct reports
• Prepare and present at subcommittees as required by the RFQ
• Actively participates in leadership/management activities to help identify internal and external challenges and opportunities. Contributes to sound organizational strategies and actions; and provides insight, feedback, and counsel to other members of the Management team.
• Works with BH Senior Leadership to determine departmental goals and to plan short- and long-term strategies to meet corporate goals.
• Complete other duties as assigned by Senior Leadership.

POSITION QUALIFICATIONS

Minimum Education:
R.N., Licensed Clinical Social Worker.
Licensed Psychologist, Licensed Marriage and Family Therapist, Licensed Mental Health Counselor, Licensed Masters Social Worker with active license in New York required.
Masters’ degree in Nursing, Business or other related area strongly preferred.

Minimum Experience:

• Seven (7) years of experience in the management of behavioral health services in a behavioral health managed care setting or a behavioral health clinical setting
• Program development experience required.
• Case Management experience/certification preferred.
• Significant experience with NCQA
• Regulatory or accreditation audit experience
• Experience in Medicaid, Medicare and Commercial products with experience working with vulnerable populations
• Experience in integrated health delivery (physical and behavioral health) a strong plus
• Experience working with Health Homes a strong plus
• Experience working with community and family-based services

Required Skills:

• Highly skilled functioning in a highly matrixed environment
• Flexible management style
• Superior communication skills; ability to organize and present data

effectively.

• Ability to use discretion in handling confidential information
• Superior priority setting and time management abilities
• Strong data and system skills
• Some travel required within MVP’s service area
• Ability to work independently and prioritize multiple assignments to meet deadlines.
• Knowledge of NYS systems of care required

About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com

Please apply and learn more – including how you may become a proud member of our team.


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