Job Description
Job Description Summary:
Behavioral Health Subject Matter Expert accountable for developing a strategic approach to BH management at the market and account level by establishing relationships with key accounts (C-suite on down) in support of internal customer needs (CBU) and external client business objectives. The role develops strong relationships with internal matrix partners that support the strategic alignment. Charged with delivering results that demonstrate value to the customer derived from identifying, demonstrating and supporting sales of behavioral health care and cost solutions as well as client retention activities. Responsible for developing and implementing BH product sales strategies. In depth knowledge of local and national challenges and solutions associated with BH. Accountable for ensuring contract compliance, developing and executing strategic plans in partnership with business units, leading cross functional teams in support of achieving client commitments for BH. Takes leadership role in working with CBU to insource BH program for clients historically outsourced to other vendors. Takes leadership role in coordinating company resources to achieve business objectives, maintain account satisfaction, and ensure the company's products and services support customer's needs.
Responsibilities:
• Leads Client Liaison team through the management, development and training of staff; develops and monitors goals; conducts annual performance reviews, and administers salaries for the staff. Develops and implements strategic and account-specific approaches to maintain contract compliance and satisfaction; partners with CBU leadership to execute BH buy up sales.
• Oversees annual sales and account management reporting cycle and ensures BH team preparedness for external presentations including all materials
• Creates and maintains partnerships with internal and external customers through the development, implementation and execution of BH strategic business plans that support client upsell and retention of profitable relationships for all lines of business (Commercial, Medicare and Medicaid)BH Expert serves as the face and voice of Horizon Behavioral Health and represents enterprise at a variety of external meetings and calls including but not limited to external sales presentations, external account presentations, operational meetings, benefit planning meetings, meetings with consultants on behalf of new/existing accounts, etc.
• Understands the client structure and culture and demonstrates the ability to apply this knowledge in business and retention planning for the client as it pertains to behavioral health services.
• Manages VIP cases and requests for elevated customer support; clinical and administrative needs; works cross divisionally to resolve complex customer issues.
• Effectively maintains relationships with key decision makers (internally and externally including CBU leadership and client account leadership).
• Develops strong relationships and contacts within the company that are supportive of the achievement of BH customer service requirements including attainment of performance guarantees and minimization of performance penalty expense.
• Serves as client consultant regarding BH regulatory environment and compliance requirements – Mental Health Parity and Addictions Equity Act (MHPAEA) both nationally and NJ specific; 42 CFR Part 2 etc.
• Provides active team leadership in addressing and resolving customer issues and complaints.
• Identifies opportunities, develops and implements programs and solutions effecting utilizing organizational resources.
• Creates ongoing and adhoc client reporting related to BH programs and services as needed.
• Oversee the analysis of data and reporting and executive summary development.
• Prepares and supports presentation of customer reports with meaningful analytics, trending and recommendations for program improvement based on findings.
• Ensures all client reports have an executive summary and explanation of data.
• Provides in-person and virtual trainings as needed for clients, client partners (EAP’s etc.) and internal team members around BH challenges, programs and services.
• Ensures BH customer and account-facing services are provided in a consistent timely fashion.
• Demonstrates the value of BH solutions (unit cost, UM and patient care enhancement).
• Identify/create opportunities for upselling additional services to support unmet BH needs in partnership with CBU.
• Responds to RFP’s for new and existing business related to BH; directly participates and supports CBU on all renewal activities. Represents Horizon in finalist presentations.
• Owns overall account satisfaction related to behavioral health operations.
• Stays abreast of market trends and assists with development of strategic approach to management of national/corporate accounts.
• Responsible for BH education, implementation and monitoring of relationships with ASO clients.
• Creates BH presentation materials and facilitates client presentations and meetings – internal and external.
Disclaimer:
This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.
Education/Experience:
• High School Diploma/GED required.
• Bachelors degree preferred or relevant experience in lieu of degree.
• Masters preferred.
• Requires minimum of 10 years managed behavioral healthcare or related experience.
• Advanced experience in account management and customer relations.
Knowledge:
• Requires knowledge of the regulatory environment including state specific laws, mandates and regulations.
• Requires knowledge of BH, managed care and health insurance industry and knowledge of the enterprise operations and products.
Skills and Abilities:
• Demonstrated ability to make decisions with little need for direction and to function effectively as a team-oriented, self-starter working across cross-functional lines.
• Demonstrated ability to manage escalated matters and drive resolution across internal and external partnerships; ability to package customer-ready responses to sensitive matters
• Must have excellent presentation skills; effective verbal and written communication skills and demonstrate the ability to work well within a team.
• Demonstrated ability to deliver highly technical information to less technical individuals. Requires familiarity with contracting concepts.
Horizon BCBS NJ is New Jersey's largest and #1 Rated Healthcare Managed Care Company.
We are a not for profit company that is highly rated (Forbes List 2024-One of the Best employers in the US).
Horizon BCBS NJ is New Jersey's largest and #1 Rated Healthcare Managed Care Company.\r\nWe are a not for profit company that is highly rated (Forbes List 2024-One of the Best employers in the US).
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