Behavioral Health Clinical Liaison
Job Description
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Job Summary: Serve as a liaison between external groups and providers regarding clinical information from the Operations and Medical Management teams.
Key Responsibilities:
? Interpret and present program results, develop data-driven analysis, and metrics to measure effectiveness and ROI of current and new programs.
? Partner with staff and departments on provider education and outreach; identify gaps and develop education efforts.
? Collaborate with regional leadership for providers requiring clinical interpretation of results related to health plan reporting, data, and quality incentive payments; facilitate discussions and make recommendations.
? Implement procedures for tracking operational issues, including issues between the provider network, community, and facility; make recommendations to solve.
? Represent the clinical team in various meetings.
? Identify internal and external opportunities to improve quality and satisfaction; initiate process changes.
? Serve as a resource and liaison on utilization, quality improvement, and case management activities.
? Perform Behavioral Health provider audits and technical assistance activities for NH Health Plan Only; track and monitor outcomes and opportunities for improvement.
? Perform other duties as assigned.
Requirements:
? Master’s in Social Work or Behavioral Health.
? 5+ years of experience in managed care, utilization management, case management, or quality improvement.
? LPC, LCSW, LMHC, or LMFT licensure (Behavioral Health only).
Centene offers a comprehensive benefits package, including competitive pay, health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off, holidays, and flexible work arrangements.