Behavioral Health Coordinator / Clinical Liaison

Amerihealth Caritas•,

1d•Hybrid

About The Position

Under the supervision of the Integrated Healthcare Management Manager, the Behavioral Health Coordinator/Clinical Liaison is responsible for identifying, assessing, planning, coordinating, and implementing appropriate, cost-effective, and quality healthcare services for individuals requiring additional assistance in accessing behavioral health services. Acts as a liaison between the Health Plan and regulatory agencies. Works collaboratively with all Health Plan departments and providers to facilitate cost-effective care and improve member outcomes.

Requirements

Bachelor’s Degree required.
Registered Nurse (RN) required.
3 years of experience working with behavioral health and/or Medicaid populations.
5 years of clinical nursing or behavioral health experience.

Nice To Haves

Licensed Social Worker (LSW) preferred.
5+ years of experience working with behavioral health and/or Medicaid populations is strongly preferred.

Responsibilities

Acts as a liaison between regulatory agencies, the Health Plan, behavioral health members, caregivers, healthcare providers, and payors.
Investigates and assists in the resolution of issues referred to the Health Plan from the Medicaid agency including, but not limited to, pharmacy, claims, member appeals, medical and dental provider network issues, care delivery, access to care, expedited enrollment, and residential and long-term placement for behavioral health members.
Participates in meetings, conference calls, and case discussions with government agencies and/or providers including, but not limited to, on-site Behavioral Health Monitoring meetings, Joint Treatment Plan Conferences, PH-MCO/BH-MCO meetings, Juvenile Court Services, and Integrated Health Homes (IHH).
Collaborates with Statutory Reporting and Medical Informatics in the preparation and review of monthly Behavioral Health reports. Provides monthly reports and analysis of operations and services as required by departmental guidelines and regulatory requirements.
Functions as a liaison with community organizations and healthcare providers. Supports and assists providers and advocates for behavioral health members in resolving questions regarding access to covered care and services.
Supports IHCM staff as they work with members, caregivers, PCPs, specialists, and providers to resolve issues affecting individual members or behavioral health populations. Monitors and coordinates reporting and resolution of issues to the Medicaid agency or other responsible government agencies.
Performs other duties and projects as assigned.