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Must reside in the Central Region of Virginia in one of the following counties: Amelia, Hanover, Petersburg,Brunswick, Henrico, Powhatan, Caroline, Hopewell, Prince Edward, Charles City, King And Queen, Prince George, Chesterfield, King George, Richmond City, Colonial Heights, King William, Richmond Co., Cumberland, Lancaster, Southampton, Dinwiddie, Lunenburg Spotsylvania, Emporia, Mathews, Stafford, Essex, Mecklenburg, Surry, Franklin City, Middlesex, Sussex, Fredericksburg, New Kent, Westmoreland, Goochland, Northumberland, Greensville, Nottoway.

Up to 25% of expected travel.

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.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 the Central Region of 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 required

Preferred 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 independently

EducationThe highest level of education desired for candidates in this position is a Master’s degree or BSN for those that are Registered Nurses

Pay Range

The typical pay range for this role is:

$80,340.00 - $173,000.00

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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 05/31/2024

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.