Behavioral Health Clinical Liaison

Centene Corporation•Remote-GA, GA

1d•$70,100 - $126,200

About The Position

Serve as a liaison for external groups and providers regarding clinical information from the 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 the effectiveness and ROI of current and new programs. Partner with staff and internal and external departments on provider education and outreach, identify gaps, and develop and deploy education efforts. Work with regional leadership to provide clinical interpretation of results related to health plan reporting, data, and quality incentive payments, and facilitate discussions that lead to recommendations. Implement and manage procedures for tracking, identifying, and resolving operational issues involving the provider network, community, and facility, and recommend solutions. Represent the clinical perspective in meetings; collaborate with staff to identify opportunities and initiate process changes that improve quality and staff, provider, and member satisfaction. Serve as a resource and liaison for utilization, quality improvement, and case management activities. Comply with all policies and standards.

Requirements

Master's degree in Social Work or Behavioral Health.
At least 4 years of experience providing behavioral health outpatient care in a community setting or independent practice.
Experience assessing treatment plans related to mental health and substance abuse across the continuum of care.
Experience with managed care, case management, utilization management, or quality improvement.
Required licensure: one of LCSW, LMHC, LPC, LMFT, or LMHP; a Licensed Clinical Psychologist is also listed as required.
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 the effectiveness and ROI of current and new programs.
Partner with staff and internal and external departments on provider education and outreach, identify gaps, and 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 to make recommendations.
Implement and manage procedures for tracking, identifying, and resolving operational issues involving the provider network, community, and facility, and make recommendations for solutions.
Act as the clinical representative in 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 a resource and liaison on utilization, quality improvement, and case management activities.
Comply with all policies and standards.