Behavioral Health Clinical Liaison

Employment Type

: Full-Time


: Miscellaneous

Job Description This will be a full-time telework role, however, will require 10-25% travel when COVID restrictions are lifted. Schedule is Monday-Friday, standard business hours. The Clinical Liaison is the clinical leader in the Medicaid plan focusing on integrating member care, clinical coordination, leading the development, implementation, and ongoing monitoring of program and quality initiatives to address the needs of Aetna members. They represent the plan and collaborate with State governments, key stakeholders, community organizations, advocacy groups as well as the Medicaid Plan's Chief Medical Officer and leadership team to enhance the quality of services provided to Aetna members and to ensure adherence to performance targets of the business area. Requires RN or LCSW or equivalent license. Partners with Plan executive leadership team to provide overall vision and leadership across all Plan activities. Serves as a key resource regarding any issues related to the integration of member care across departments. Consults with Plan executive management regarding physical and behavioral health clinical issues as they relate to medical management (UM, CM, DM) provider and system of care issues, behavioral health and human services system issues including critical stakeholders such as various departments of state government, provider organizations, advocacy organizations, etc. Partners with Aetna Medicaid's regional psychiatrist(s) to manage and oversee ICM within the health plan. Provides consultation to support physicians at other Medicaid Plans. Participates in organizational planning, including strategic plans, business plans, and new product development. Elicits staff input related to their job functions and leverages errors and failure to reach performance targets as opportunities for organizational learning and improvement. Supports and encourages CM, UM, and DM staff to function as interdisciplinary team, with requisite range and depth of subject matter expertise to meet the needs of the covered population. Represents Plan to relevant external stakeholders, such as state government officials, providers/vendors, & advocacy groups with regard to quality improvement initiatives, integrating member care, health plan success, and innovative care strategies.With the plan's physician leader, co-facilitates interdisciplinary case rounds to address the needs of members with complex clinical presentations, identifies opportunities for improving rounds, and works with the clinical leadership team to optimize the value of rounds to the clinical staff. Demonstrates knowledge about established and evolving biomedical, clinical, epidemiologic, and social-behavioral sciences and the application of this knowledge to member care. Participate in and support process improvement initiatives within care management and across broader Plan operations. Required Qualifications REQUIRED5+ years of managed care experience in behavioral health required1+ year(s) of previous supervisory or management experience required 1+ year(s) of experience in handling mental health and psychiatric care, family situations, or relationship concerns requiredPREFERREDStrong verbal and written communication skills and the ability to communicate effectively with all levels of management preferredExperience with third-party relationships, including BJH MCOs, local community-building efforts, governmental and regulatory authorities preferred Supervisory, management, and administrative experience, excellent consultative skills, analytical ability, decisiveness, strong judgment preferred LICENSUREMaster's degree in social work or related field required.LCSW or Licensed Behavioral Health Clinician (LPC, LMFT, Ph.D., or Psy.D), or RN with current unrestricted state licensure required. Preferred Qualifications Please review required qualifications above Education Bachelor's degree or equivalent experience Business Overview At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart. We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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