Commonwealth Care Alliance-posted 2 months ago
Full-time
Boston, MA
Religious, Grantmaking, Civic, Professional, and Similar Organizations

The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating strong, collaborative relationships with behavioral health providers and driving performance improvement through data insights, education, and partnership. This individual will serve as the primary point of contact for BH providers, promoting alignment with CCA's mission and supporting high-quality, coordinated care for members. In this role, the Program Manager acts as an account manager, relationship manager, and performance partner - using data, provider feedback, and system collaboration to enhance provider engagement, improve outcomes, and strengthen community-based partnerships. This position works closely with CCA's Behavioral Health, Health Home, Network, and Clinical teams to ensure a seamless provider experience and consistent delivery of quality care. The BH Provider Engagement Program Manager reports to the Director of Delegation Partnerships and Provider Engagement.

  • Serve as the primary relationship manager and point of contact for assigned BH providers, fostering collaboration and problem-solving.
  • Represent CCA's behavioral health priorities, programs, and initiatives to the provider network.
  • Promote provider understanding of CCA's mission, value-based approach, and expectations for quality, utilization, and member experience.
  • Address provider inquiries related to care coordination, utilization management, and program participation, collaborating with internal teams as needed.
  • Analyze and interpret provider data related to utilization, cost, quality, and outcomes to identify performance trends and opportunities for improvement.
  • Develop and share actionable performance reports with providers to support data-driven quality improvement.
  • Collaborate with internal analytics and clinical teams to ensure data insights are accurate, meaningful, and aligned with organizational priorities.
  • Track provider progress on performance metrics (e.g., HEDIS, readmissions, community tenure) and follow up to support improvement efforts.
  • Partner with the Health Home and Clinical teams to support consistency and quality across BH and Health Home providers.
  • Participate in case review meetings and rounds as needed to enhance coordination and care transitions.
  • Support the identification and implementation of innovative provider initiatives, pilots, and clinical improvement projects.
  • Build linkages between levels of behavioral health care - from inpatient to community-based - to improve transitions and continuity of care.
  • Work closely with the Network and Business Development teams to ensure information and insights are shared bidirectionally.
  • Collaborate with cross-functional leaders, including community organizations, PCPs, and social service agencies, to strengthen relationships and community integration.
  • Partner with the Behavioral Health leadership team to support initiatives related to value-based payment (VBP), quality improvement, and provider engagement.
  • Manage assigned provider relationships and related projects to meet defined goals for engagement, quality, and performance.
  • Develop and execute annual provider engagement plans informed by provider data, feedback, and CCA priorities.
  • Follow through on performance improvement activities, monitoring impact and adjusting approach as needed.
  • Support departmental projects and initiatives as assigned.
  • Represent the Behavioral Health team in cross-functional meetings and external stakeholder discussions.
  • Master's degree in a behavioral health discipline (Psychology, Social Work, Counseling, or related field) or equivalent experience required.
  • 5+ years of experience.
  • Experience with Medicaid and Medicare products and programs.
  • Experience or knowledge of behavioral health services available to support dual eligible populations.
  • Experience in behavioral health clinical practice, provider relations, or healthcare management.
  • Experience working with managed care organizations, value-based programs, or community-based behavioral health providers strongly preferred.
  • Experience with dual-eligible (SCO or One Care) populations preferred.
  • Experience in healthcare program management, provider relations, or network management.
  • Knowledge of Massachusetts BH landscape.
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