Behavioral Health Clinical Liaison

Centene Management Company•Clayton, MO
•Remote

About The Position

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. This is a remote position. Candidate must reside in and be licensed in the state of Missouri. Outpatient experience strongly preferred. 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 Performs other duties as assigned. Complies with all policies and standards.

Requirements

  • 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
  • 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
  • State specific licensure may be required for the following states: AZ, FL, GA, NV, SC, NC, and WA required
  • Candidate must reside in and be licensed in the state of Missouri.

Nice To Haves

  • Outpatient experience strongly preferred.

Responsibilities

  • Serve as a liaison for external groups and providers regarding clinical information from the Operations and Medical Management teams.
  • Assess and perform 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.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Benefits

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