The purpose of a Behavioral Health Specialist at Oak Street Health is to provide care management services and to provide evidence-based short-term psychotherapy to our patients with behavioral health needs. The Behavioral Health Specialist is a key resource for Care Teams across a region of Oak Street Health primary clinics. They are responsible for coordinating and supporting behavioral healthcare for our patients, in collaboration with Care Teams and a psychiatric consultant. Assess the needs of patients and make referrals to appropriate behavioral health resources and specialists Provide short-term counseling and evidence-based treatments as indicated Collaborate with the primary care teams to identify appropriate patients to refer to the Oak Street Behavioral Health Program Screen and assess patients for common mental health and substance use disorders Develop care plans and provide or facilitate referrals to Oak Street’s psychiatric consultant and/or external resources Coordinate care with Oak Street’s psychiatric consultant, including warm handoffs for telehealth visits and collaboration on care plans Develop relationships with primary care teams and consistently communicate changes in behavioral health care plans Accurate and timely documentation of patient encounters and counseling sessions in Oak Street’s electronic medical record Participate in regional and organizational efforts to advance Oak Street’s Behavioral Health Program through workshops, feedback sessions, and surveys Possibly covering multiple clinics, depending on the maturity and panel sizes of those clinics Other duties, as assigned

• Assist the CMO with monitoring availability, appropriateness, and necessity of care rendered by participating providers and by out-of-plan providers • Participate in oversight and clinical decision making of the UM program, including but not limited to rendering denial determinations for services not considered medically necessary or experimental/investigation/unproven in accordance with regulatory and quality standards • Contribute to the development of quality care guidelines, internal peer review procedures, and the evaluation of medical care evaluation studies under the NHP quality assurance programs • In coordination with the CMO and Directors of Health Management and QI and Disease Management, share responsibility for the development and continued evaluation of utilization review and quality assessment processes • Provide medical consultation as requested for: • Medical/legal issues • Member grievance procedures • Development and implementation of new benefit packages and the interpretation of covered benefits in NHP contracts • Medical issues related to contract negotiations with health care providers • Determining if services to members/enrollees meet medical criteria • Promote positive relationship between NHP and medical community • Serve as liaison between NHP and providers regarding matters of medical policy and medical administration • Serve as spokesperson for NHP in the medical community and maintains appropriate contact with professional health care organizations • Participate in the ongoing recruitment of plan physicians. • Respond to physicians and other provider inquiries and complaints within established guidelines of the Executive Committee and Board of Directors • Assist in the development of appropriate medical guidelines and parameters for claims review • Assist in the training of NHP staff on matters relating to medical guidelines • Oversight responsibility for monitoring and evaluating Medicare Special Needs Plan Model of Care effectiveness • Perform second level review of provider appeals and disputes • Serve on committees as coordinated with the CMO • Assist in strategic planning targeted towards plan growth initiatives

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Impact Advisors is seeking a dynamic and motivated Training & Testing Director to join our Oracle Health team. In this role, you will be instrumental in leading enterprise-wide training and testing strategy for complex EHR implementations. This position offers a unique opportunity to contribute to client success while making a meaningful impact on the healthcare industry. - Develop and oversee role-based training programs across clinical, ancillary, and revenue cycle teams. - Lead integrated testing strategy including unit, integrated, user acceptance, and dress rehearsal testing. - Establish measurable proficiency standards and remediation strategies to ensure safe system activation. - Oversee environment management, training logistics, super user programs, and at-the-elbow support models. - Manage multidisciplinary teams and coordinate vendor resources to ensure alignment with program milestones. Qualifications - Bachelor’s degree required; advanced degree preferred. - 10+ years healthcare IT experience, 5+ years leading training and/or testing for large EHR implementations, Oracle Health (Cerner) experience strongly preferred. - Enterprise program governance. - Clinical workflow understanding. - Large-scale training operations management. - Risk identification and mitigation. - Strong executive communication skills. Requirements - Up to 50% travel. Benefits - Hourly pay rate of $90-110. - For salaried positions, this role may also be eligible for an annual performance bonus. - Additional benefits and perks may also be available, depending on the position and employment terms.

• Perform all types of utilization management (UM) reviews, including but not limited to Pre-service, Post-service, Concurrent Review and Appeals • Discuss cases with physician providers (Peer to Peer) • Apply health plan review hierarchy to member contracts, medical policy, clinical guidelines and other approved resources to render timely decisions on medical necessity requests • Collaborate with Case Managers to provide support and guidance on cases needing physician assistance • Meet any established metrics (compliance and accreditation) related to UM review efficiency, timeliness, and quality of review • Participate in ongoing Inter-rater reliability (IRR) audits and any other health plan audits as necessary • As necessary, assist nurses and other staff in understanding the principles behind appropriate utilization review and interpretation and application of benefits and policies • Participate in the development and review of Medical and Pharmacy policies as assigned • Support the organization as a subject matter expert • Perform as lead Medical Director consultant for one sub-category of utilization management, such as commercial or Medicare medical policy • Perform other duties as assigned and needed by the organization