At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Up to 25% of expected travel in Virginia region of residence.Standard business hours: Monday-Friday.The Behavioral Health Clinical Liaison is a 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 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.
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Fundamental Components:
- 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 high utilizers to support 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 the respective region
- Interface with community stakeholders to foster collaboration and provide education and training
- 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
- 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 with regard to 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, 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.
- Participates/ supports process improvement initiatives within care management and across broader Plan operations.
Required Experience:
- One of the following active and good standing licenses is required for the state of Virginia: RN, LCSW, LPC, LMFT, LBA
- Must reside in Virginia.
- Minimum 2+ years experience required working for a managed care organization (MCO).
- Minimum 5+ years clinical experience
- 5+ years of experience in behavioral health, mental health, psychiatric care, substance abuse disorder required
-Minimum 5+ years of clinical and program oversight experience required, preferably in behavioral health, mental health, psychiatric care required
- Proficiency with MS Office Suite, WORD, Excel, Outlook, etc. and strong keyboard navigation skills are required.
- 2+ years of experience with delivery/ supervision of community-based Medicaid behavioral health services requiredPreferred Experience:
- Experience in completing utilization management tasks preferred
-Demonstrated leadership competency and strong relationship builder; self-motivated and confident making decisions, ability to influence and shape clinical outcomes, a strong clinical consultant.
- Possesses strong analytical, verbal and written communication skills; demonstrated ability to communicate effectively with all levels of management, including senior leadership.
- Ability to work independentlyEducation
The highest level of education desired for candidates in this position is a Master's degree or BSN for those that are Registered Nurses Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:$80,340.00 - $173,040.00This 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.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.