Behavioral Health Clinical Liason

Centene Corporation•Remote-NV, NV

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, 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 when providers need clinical interpretation of results related to health plan reporting, data, and quality incentive payments, and facilitate discussions to make recommendations. Implement and manage procedures to track, identify, and resolve operational issues, including those involving the provider network, community, and facility. Serve as the clinical representative in meetings and as a resource and liaison for utilization, quality improvement, and case management activities. Collaborate with staff to identify opportunities and initiate process changes that improve quality and staff, provider, and member satisfaction. Comply with all policies and standards. Centene offers a comprehensive benefits package, including competitive pay, health insurance, a 401(k) and stock purchase plans, tuition reimbursement, paid time off, and holidays. Work schedules may be remote, hybrid, field, or office-based, with a flexible approach. Actual pay is adjusted based on individual skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may include additional incentives, and benefits may be subject to program eligibility.

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.
One of the following licenses or certifications is required: LCSW, LMHC, LPC, LMFT, LMHP, or Licensed Clinical Psychologist.
State-specific licensure may be required in 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 analysis and metrics to measure program effectiveness and ROI.
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 health plan reporting, data, and quality incentive payment results; facilitate discussions and make recommendations.
Implement and manage procedures for tracking, identifying, and problem-solving operational issues involving the provider network, community, and facility, and recommend 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.