Behavioral Health Manager. The Contractor shall employ a Behavioral Health Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Behavioral Health Manager is responsible for ensuring that the Contractor’s behavioral health operations, which include the operations of any behavioral health subcontractors, are in compliance with the terms of the Contract. The Behavioral Health Manager shall coordinate with all functional areas, including quality management, utilization management, network development and management, provider relations, member outreach and education, member services, contract compliance and reporting. The Behavioral Health Manager shall fully participate in all quality management and improvement activities, including participating in Quality Strategy Committee meetings and in the Mental Health Quality Assurance Committee. The Behavioral Health Manager shall work closely with the Contractor’s network development and provider relations staff to develop and maintain the behavioral health network and ensure that it is fully integrated with the physical health provider network. The Behavioral Health Manager shall collaborate with key staff to ensure the coordination of physical and behavioral health care as set forth in Section 3.7 and coordination with Medicaid Rehabilitation Option (MRO) and 1915(i) services as set forth in Sections 3.11.1 and 3.11.2. The Behavioral Health Manager shall work closely with the utilization management staff to monitor behavioral health utilization, especially to identify and address potential behavioral health under- or over-utilization. The Behavioral Health Manager or designee shall be the primary liaison with behavioral health community resources, including Community Mental Health Centers (CMHCs), and be responsible for all reporting related to the Contractor’s provision of behavioral health services. If the Contractor subcontracts with a behavioral health organization (BHO) to provide behavioral health services, the Behavioral Health Manager shall continue to work closely with the Contractor’s other managers to provide monitoring and oversight of the BHO and to ensure the BHO’s compliance with the Contract. (See Section 2.7 regarding requirements for OMPP’s approval of subcontractors.)
Behavioral Health Manager. The Contractor must employ a Behavioral Health Manager who is dedicated full-time to the Hoosier Care Connect program. The Behavioral Health Manager is responsible for ensuring that the Contractor’s behavioral health operations, which include the operations of any behavioral health subcontractors, are in compliance with the terms of the Contract. The Behavioral Health Manager must coordinate with all functional areas, including quality management, utilization management, network development and management, provider relations, member outreach and education, member services, contract compliance and reporting. The Behavioral Health Manager must fully participate in all quality management and improvement activities, including participating in Quality Strategy Committee and Subcommittee meetings and in the Mental Health Quality Assurance Committee. The Behavioral Health Manager must work closely with the Contractor’s network development and provider relations staff to develop and maintain the behavioral health network and ensure that there is communication, collaboration and coordination with the physical health provider network. The Behavioral Health Manager shall collaborate with key staff to ensure the coordination of physical and behavioral health care as set forth in Section 3.10.2 and coordination with Medicaid Rehabilitation Option (MRO) and 1915(i) services
Behavioral Health Manager. The Contractor shall employ a Behavioral Health Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Behavioral Health Manager is responsible for ensuring that the Contractor’s behavioral health operations, which include the operations of any behavioral health subcontractors, are in compliance with the terms of the Contract. The Behavioral Health Manager shall coordinate with all functional areas, including quality management, utilization management, network development and management, provider relations, member outreach and education, member services, contract compliance and reporting. The Behavioral Health Manager shall fully participate in all quality management and improvement activities, including participating in Quality Strategy Committee meetings and in the Mental Health Quality Assurance Committee. The Behavioral Health Manager shall work closely with the Contractor’s network development and provider relations staff to develop and maintain the behavioral health network and ensure that it is fully integrated with the physical health provider network. The Behavioral Health Manager shall collaborate with key staff to ensure the coordination of physical and behavioral EXHIBIT 2.H HEALTHY INDIANA PLAN SCOPE OF WORK
Behavioral Health Manager. The Contractor shall employ a Behavioral Health Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Behavioral Health Manager is responsible for ensuring that the Contractor’s behavioral health operations, which include the operations of any behavioral health
Behavioral Health Manager. The Contractor must employ a Behavioral Health Manager who is dedicated full-time to the Hoosier Care Connect program. The Behavioral Health Manager is responsible for ensuring that the Contractor’s behavioral health operations, which include the operations of any behavioral health subcontractors, are in compliance with the terms of the Contract. The Behavioral Health Manager must coordinate with all functional areas, including quality improvement, utilization management, network development and management, provider relations, member outreach and education, member services, contract compliance and reporting. The Behavioral Health Manager must fully participate in all quality management and improvement activities, including participating in Quality Strategy Committee and Subcommittee meetings and in the Mental Health Quality Assurance Committee. The Behavioral Health Manager
Behavioral Health Manager. The Contractor shall employ a Behavioral Health Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Behavioral Health Manager is responsible for ensuring that the Contractor’s behavioral health operations, which include the operations of any behavioral health subcontractors, are in compliance with the terms of the Contract. The Behavioral Health Manager shall coordinate with all functional areas, including quality management, utilization management, network development and management, provider relations, member outreach and education, member services, contract compliance and reporting. The Behavioral Health Manager shall fully participate in all quality management and improvement activities, including participating in Quality Strategy Committee meetings EXHIBIT 1.E SCOPE OF WORK – HOOSIER HEALTHWISE
Behavioral Health Manager. The Contractor shall employ a Behavioral Health Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Behavioral Health Manager is responsible for ensuring that the Contractor’s behavioral health operations, which include the operations of any behavioral health subcontractors, are in compliance with the terms of the Contract. The Behavioral Health Manager shall coordinate with all functional areas, including quality management, utilization management, network development and management, provider relations, member outreach and education, member services, contract compliance and reporting. The Behavioral Health Manager shall fully participate in all quality management and improvement activities, including participating in Quality Strategy Committee meetings and in the Mental Health Quality Assurance Committee. The Behavioral Health Manager shall work closely with the Contractor’s network development and provider relations staff to develop and maintain the behavioral health network and ensure that it is fully integrated with the physical health provider network.
Behavioral Health Manager. The Contractor shall employ a Behavioral Health Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Behavioral Health Manager is responsible for ensuring that the Contractor’s behavioral health operations, which include the operations of any behavioral health subcontractors, are in compliance with the terms of the Contract. The Behavioral Health Manager shall coordinate with all functional areas, including quality improvement, utilization management, network development and management, provider relations, member outreach and education, member services, contract compliance and reporting. The Behavioral Health Manager shall fully participate in all quality management and improvement activities, including
Behavioral Health Manager. The Contractor shall employ a Behavioral Health Manager who is dedicated full- uct lines. behavioral health operations, which include the operations of any behavioral health subcontractors, are in compliance with the terms of the Contract. The Behavioral Health Manager shall coordinate with all functional areas, including quality management, utilization management, network development and management, provider relations, member outreach and education, member services, contract compliance and reporting. The Behavioral Health Manager shall fully participate in all quality management and improvement activities, including participating in Quality Strategy Committee meetings and in the Mental Health Quality Assurance Committee. The Behavioral Health Manager s
Behavioral Health Manager. Shall be an Iowa licensed behavioral health professional such as a psychologist, psychiatrist, social worker, psychiatric nurse, marriage and family therapist or mental health counselor, with experience in both mental health and substance use disorder services. The Behavioral Health Manager shall ensure that the Contractor’s behavioral health operations, which include the operations of any behavioral health Subcontractors, are in compliance with the terms of the Contract. The Behavioral Health Manager shall coordinate with all functional areas, including Quality management, UM, Network development and management, Provider relations, Member outreach and education, Member services, Contract compliance and reporting. If the Contractor subcontracts with a behavioral health organization (BHO) to provide Behavioral Health Services, the Behavioral Health Manager will continue to work closely with the Contractor’s other managers to provide monitoring and oversight of the BHO and to ensure the BHO’s compliance with the Contract.
