Behavioral Health Clinical Liaison - Work at Home - Virginia

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

The Behavioral Health Clinical Liaison is a clinical leader in the Medicaid plan focusing on utilization management, integrating member care, clinical coordination, leading the development, and the implementation and ongoing monitoring of program and quality initiatives to address the needs of Aetna members. They represent the plan and collaborate with internal partners, community organizations, and behavioral health and ARTS providers to enhance the quality of services provided to Aetna members and to ensure adherence to performance targets of the business area.

• Clinically manage non-traditional mental health services and addiction recovery and treatment services through the utilization management process
• Drives collaboration on quality of care, utilization management, disparities, and care coordination to ensure optimal member outcomes.
• Outreach to at-risk member supports to drive treatment coordination, transitions of care, and appropriate discharge planning.
• Serve as the behavioral health subject matter expert to support care management staff in serving Aetna members in their respective region.
• Interface with community stakeholders to foster collaboration and provide education and training.
• Supports and encourages CM and UM 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, providers/vendors, & advocacy groups regarding quality improvement initiatives, integrating member care, health plan success, and innovative care strategies.
• Participate in interdisciplinary case rounds to address the needs of members with complex clinical presentations, identifies opportunities for improving rounds
• Demonstrates knowledge about established and evolving biomedical, clinical, epidemiologic, and social-behavioral sciences and the application of this knowledge to member care.- Participates/ supports process improvement initiatives within care management and across broader Plan operations.

• Must reside in Virginia
• Must be licensed in Virginia as a Licensed Clinical Social Worker, Licensed Professional Counselor, Licensed Marriage and Family Therapist, Licensed Behavior Analyst or a RN with a psych background in the state of Virginia.
• 2+ years experience with delivery of community-based Medicaid behavioral health services
• 5+ years of clinical experience in behavioral health, mental health, psychiatric care.
• Must be willing and able to travel up to 10% within the assigned region for provider meetings and community based events
• Proficiency with MS Office Suite, WORD, Excel, Outlook, etc. and strong keyboard navigation skills are required.

• 2+ years experience working for a managed care organization (MCO).
• Experience with supervision of community-based Medicaid behavioral health services.
• Experience in completing utilization management tasks
• Demonstrated leadership competency, self-motivated and confident making decisions
• A strong clinical consultant
• Demonstrated ability to complete care coordination tasks
• Demonstrated ability to work independently
• Ability to manage multiple tasks concurrently
• Demonstrated ability to meet deliverables timely

• Master’s degree in Behavioral Health field
• If RN, Bachelor's degree required

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

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