Population Health Specialist, ABA services - Hybrid (PA/NJ/DE)

Independence Blue Cross

  • Philadelphia, PA
  • Permanent
  • Full-time
  • 10 days ago
Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals. If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.The Population Health Specialist for Autism /Applied Behavioral Analysis (ABA) Services leads initiatives and programs to enhance access and quality, across multiple provider types, access channels and in collaboration with other IBC quality, population, and value initiatives. * Supports behavioral health leadership in implementing initiatives in multi-year strategy to enhance behavioral health services and programs, including autism/ neurodiversity access strategies, advocacy throughout the IBX system for neurodiversity inclusion and best practice approaches to supporting neurodivergent population health, including but not limited to autism care management program development2. Participates in identification, development and valuation of opportunities for holistic autism program development including access strategies, provider quality and partnership opportunities, outcomes measurement, and process improvement * Develops autism provider performance measurement approaches and contributes to enterprise performance initiatives for behavioral health. Coordinates with stakeholders to integrate behavioral health measurement in current and future quality improvement methodologies. Supports provider relationship development to improve access and increase focus on clinical outcomes.
  • Partners with network and IBX stakeholders in support of operationalizing best-in-class Autism program including:
  • Work directly with providers to foster positive relationships, including developing provider-facing communications to enhance provider satisfaction and understanding of IBX processes and expectations of providers
  • Deliver training and education to support quality results and member experience
  • Lead regular meetings to discuss processes, data /quality measurement, progress, improvement initiatives, quality campaigns, address care gaps
  • Other activities in support of ASD care management operations including: access/capacity management system to support care navigation and connection to care, utilization and care management, identification and implementation of best practices in autism /neurodiversity programming designed to drive value.
  • Serves as point of contact and facilitates resolution of administrative issues for ABA providers including claims, credentialing, and other key services
  • Collaborates with data and actuarial services to demonstrate the impact of interventions via medical cost offset.
  • Role includes an operational focus requiring project management competencies, data analyses, program goals, success measures, performance specifications, and output requirements to drive program development and execution progress.
Qualifications - External
  • Bachelor's degree; Master's degree in health-related fields a plus (e.g. MA, MPH)
Experience, Knowledge, and Skills
  • Ability to travel in the Greater Philadelphia area preferred (driver's license and insured vehicle)
  • 3-5 years' experience working with children and or adults with autism, experience providing case management or utilization management services for people with autism spectrum disorder.
  • Experience interacting with behavioral health providers, preferably ABA providers, in a professional, respectful manner that facilitates the treatment process.
  • Demonstrated knowledge and experience with quality autism care, autism care management programming and processes, behavioral health measures and quality outcomes
  • Demonstrated experience with HEDIS® measures required
  • Knowledge of medical billing, claims processing systems, and health care information terminology preferred
  • Strong verbal and written communication skills including but not limited to effective group presentations to professional staff and management
  • Must be self-motivated, organized, and detail oriented, assume a collaborative role in ensuring that all objectives are met
  • Must be able to work moderate complexity tasks independently
  • Must have strong knowledge of Microsoft Office products (Outlook, Word, Excel, and PowerPoint)
  • Must have strong analytical, influencing, and problem-solving skills
  • Must be a team player- builds team spirit and interdepartmental rapport, using effective problem-solving and motivational strategy
  • Must have a strong commitment to total quality management and process improvement
  • Acts as a resource for department, using focused professionalism and effective interactions
  • Embrace the diversity of our workplace and show respect for colleagues internally and externally
HybridIndependence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.Inclusion and BelongingAt IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.About Our CompanyServing more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group - together with its subsidiaries - is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.At Independence, we see each of our members as an individual, with unique needs and concerns. We're dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at . We're revolutionizing health care, and our focus is on you!Equal Employment OpportunityIBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.Agency DisclaimerAll resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.

Independence Blue Cross