Behavioral Health Clinical Liaison

Centene Corporation•Remote-MO, MO

1d•$70,100 - $126,200

About The Position

Serve as a liaison for external groups and providers regarding clinical information from Operations and Medical Management teams. Assess and review member clinical records and services related to behavioral health and substance use. Interpret and present program results, develop data-driven analyses and metrics to measure program effectiveness and return on investment, and partner with internal and external teams on provider education and outreach. Identify gaps in education and help develop and deploy education efforts. Work with regional leadership to interpret results related to health plan reporting, data, and quality incentive payments, and facilitate discussions and recommendations. Implement and manage procedures for tracking and resolving operational issues involving the provider network, community, and facility. Represent the clinical perspective in meetings, collaborate on process changes to improve quality and satisfaction, and serve as a resource and liaison for utilization, quality improvement, and case management activities. Comply with all policies and standards. A master's degree in social work or behavioral health and at least four years of behavioral health outpatient care experience in a community setting or independent practice are required. Experience assessing treatment plans for mental health and substance abuse across the continuum of care, and experience with managed care, case management, utilization management, or quality improvement, are also required. Missouri residency and one of the listed professional licenses are required. Pay range is $70,100–$126,200 per year. Centene offers a comprehensive benefits package and a flexible approach to work, with remote, hybrid, field, or office schedules; the specific workplace arrangement is not stated.

Requirements

Missouri residency is required.
A master's degree in social work or behavioral health is required.
At least four years of experience providing behavioral health outpatient care in a community setting or independent practice is required.
Experience assessing treatment plans related to mental health and substance abuse across the continuum of care is required.
Experience with managed care, case management, utilization management, or quality improvement is required.
One of the following licenses is required: LCSW, LMHC, LPC, LMFT, LMHP, or Licensed Clinical Psychologist. State-specific licensure may be required for AZ, FL, GA, NV, SC, NC, and WA.

Responsibilities

Serve as a liaison for external groups and providers regarding clinical information from Operations and Medical Management teams.
Assess and review member clinical records and services related to behavioral health and substance use.
Interpret and present program results and develop data-driven analyses and metrics to measure effectiveness and return on investment of current and new programs.
Partner with internal and external staff and departments on provider education and outreach; identify gaps and help develop and deploy education efforts.
Partner with regional leadership to provide clinical interpretation of results related to health plan reporting, data, and quality incentive payments, and facilitate discussions and recommendations.
Implement and manage procedures for tracking, identifying, and resolving operational issues involving the provider network, community, and facility; make recommendations for solutions.
Act as the clinical representative in meetings.
Collaborate with staff to identify opportunities and initiate process changes that increase quality and improve staff, provider, and member satisfaction.
Serve as a resource and liaison on utilization, quality improvement, and case management activities.
Comply with all policies and standards.