Behavioral Health Clinical Liaison

Centene

15d • Remote

About The Position

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Florida Licensure required Must be FL licensed minimum 4 years Behavioral Health Position Purpose: Serve as a liaison for external groups and providers regarding clinical information from the Operations and Medical Management teams. Assesses and performs review of member clinical records and services related to behavioral health and substance use. Interpret and present program results and develop data-driven analysis and metrics used to measure effectiveness and ROI of all current and new programs Partner with various staff, along with internal and external departments on provider education and outreach; determine where there are gaps and work to develop and deploy education efforts Partner with regional leadership for providers requiring a clinical interpretation of results related to health plan reporting, data and quality incentive payments; facilitate discussions to make recommendations Implement and manage procedures for tracking, identifying and problem-solving operational issues, including issues between the provider network, community, and the facility, and make recommendations to solve Act as the clinical representative in various meetings Collaborate with staff to identify internal and external opportunities and initiate process changes to increase quality and improve staff, provider and member satisfaction Serve as resource and liaison on utilization, quality improvement, and case management activities For NH Health Plan Only: Perform Behavior Health provider audits and technical assistance activities. Track and monitor outcomes and opportunities for improvement. Participate with the BH program functions and operations. Participate in exhibit O or any additional reporting requirements. Local travel required for in-person events, projects, auditing and community engagement activities Performs other duties as assigned. Complies with all policies and standards. Florida Licensure required Must be FL licensed minimum 4 years Behavioral Health

Requirements

• Florida Licensure required
• Must be FL licensed minimum 4 years Behavioral Health
• Master's Degree In Social Work or Behavioral Health required
• 4+ years experience providing behavioral health outpatient care in a community setting or independent practice required
• Experience with assessment of treatment plans related to mental health and substance abuse across the continuum of care required
• Experience with managed care, case management, utilization management, or quality improvement required
• For Applied Behavior Analysis Services (ABA) 2+ years of experience providing ABA services required
• Behavioral health clinical knowledge and ability to review and/or assess ABA treatment plans required
• Knowledge of ABA services required
• LCSW - Licensed Clinical Social Worker required or LMHC - Licensed Mental Health Counselor required or LPC - Licensed Professional Counselor required or LMFT - Licensed Marital and Family Therapist required or LMHP - Licensed Mental Health Professional required or Licensed Clinical Psychologist required or:
• State specific licensure may be required for the following states: AZ, FL, GA, NV, SC, NC, and WA required or
• For Applied Behavior Analysis Service (ABA) Board Certified Behavior Analyst (BCBA) preferred: Licensed Behavior Analyst (LBA) where required by state

Nice To Haves

• Experience working with providers and healthcare teams to review care services related to Applied Behavioral Analysis Services preferred

Responsibilities

• Serve as a liaison for external groups and providers regarding clinical information from the Operations and Medical Management teams.
• Assesses and performs review of member clinical records and services related to behavioral health and substance use.
• Interpret and present program results and develop data-driven analysis and metrics used to measure effectiveness and ROI of all current and new programs
• Partner with various staff, along with internal and external departments on provider education and outreach; determine where there are gaps and work to develop and deploy education efforts
• Partner with regional leadership for providers requiring a clinical interpretation of results related to health plan reporting, data and quality incentive payments; facilitate discussions to make recommendations
• Implement and manage procedures for tracking, identifying and problem-solving operational issues, including issues between the provider network, community, and the facility, and make recommendations to solve
• Act as the clinical representative in various meetings
• Collaborate with staff to identify internal and external opportunities and initiate process changes to increase quality and improve staff, provider and member satisfaction
• Serve as resource and liaison on utilization, quality improvement, and case management activities
• For NH Health Plan Only: Perform Behavior Health provider audits and technical assistance activities.
• Track and monitor outcomes and opportunities for improvement.
• Participate with the BH program functions and operations.
• Participate in exhibit O or any additional reporting requirements.
• Local travel required for in-person events, projects, auditing and community engagement activities
• Performs other duties as assigned.
• Complies with all policies and standards.

Benefits

• Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees