Behavioral Health Clinical Liaison - Work at Home - Virginia
About The Position
The Behavioral Health Clinical Liaison is a clinical leader in the Medicaid plan, focusing on utilization management, integrating member care, clinical coordination, and leading the development, implementation, and ongoing monitoring of program and quality initiatives that address Aetna members’ needs. The liaison represents the plan and collaborates with internal partners, community organizations, and behavioral health and ARTS providers to enhance service quality and ensure adherence to business-area performance targets. The role clinically manages non-traditional mental health and addiction recovery and treatment services through utilization management. It supports care management staff as a behavioral health subject matter expert, coordinates with community stakeholders, represents the plan to external stakeholders, and participates in interdisciplinary case rounds and process improvement initiatives. The position is work at home, requires residence in Virginia, and may involve up to 10% travel within the assigned region. The schedule is Monday through Friday, 8 a.m. to 5 p.m., with occasional on-call holiday weekend coverage.
Requirements
- Must reside in Virginia.
- Must hold a Virginia license as a Licensed Clinical Social Worker, Licensed Professional Counselor, Licensed Marriage and Family Therapist, Licensed Behavior Analyst, or a registered nurse with a psychiatric background.
- At least 2 years of experience delivering community-based Medicaid behavioral health services.
- At least 5 years of clinical experience in behavioral health, mental health, or psychiatric care.
- Must be willing and able to travel up to 10% within the assigned region.
- Proficiency with Microsoft Office, including Word, Excel, and Outlook, and strong keyboard navigation skills.
- Master’s degree in a behavioral health field; if the candidate is an RN, a bachelor’s degree is required.
Nice To Haves
- At least 2 years of experience working for a managed care organization (MCO).
- Experience supervising community-based Medicaid behavioral health services.
- Experience completing utilization management tasks.
- Demonstrated leadership competency, self-motivation, and confidence making decisions.
- Strong clinical consultation skills.
- Demonstrated ability to complete care coordination tasks.
- Demonstrated ability to work independently.
- Ability to manage multiple tasks concurrently.
- Demonstrated ability to meet deliverables on time.
Responsibilities
- Clinically manage non-traditional mental health services and addiction recovery and treatment services through the utilization management process.
- Drive collaboration on quality of care, utilization management, disparities, and care coordination to support optimal member outcomes.
- Conduct outreach to at-risk member supports to promote treatment coordination, transitions of care, and appropriate discharge planning.
- Serve as the behavioral health subject matter expert supporting care management staff in serving members in the assigned region.
- Interface with community stakeholders to foster collaboration and provide education and training.
- Support and encourage care management and utilization management staff to function as an interdisciplinary team with the subject matter expertise needed to serve the covered population.
- Represent the plan to external stakeholders, providers, vendors, and advocacy groups on quality improvement initiatives, integrated member care, health plan success, and innovative care strategies.
- Participate in interdisciplinary case rounds for members with complex clinical presentations and identify opportunities to improve the rounds.
- Apply knowledge of established and evolving biomedical, clinical, epidemiologic, and social-behavioral sciences to member care.
- Participate in and support process improvement initiatives within care management and broader plan operations.
- Travel up to 10% within the assigned region for provider meetings and community-based events.
- Provide occasional on-call holiday weekend coverage.
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources, based on eligibility
- Eligible for a CVS Health bonus, commission, or short-term incentive program
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What This Job Offers
Job Type
Full-time
Career Level
Senior
