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Centene

Runs government-backed health insurance plans

Behavioral Health Clinical Liaison

Mental & Behavioral HealthPosted on Nov 10
Full-timeGeorgia, USA$70.1k - $126.2k /yrRemote

About the Job

Requirements

  • A master's degree in Social Work or Behavioral Health is required.
  • A Georgia license as an LCSW, LMHC, LPC, LMFT, or LMHP is required.
  • At least 4 years of experience providing behavioral health outpatient care in a community setting or independent practice is required.
  • Experience assessing treatment plans related to mental health and substance abuse across the continuum of care is required.
  • Experience with managed care, case management, utilization management, or quality improvement is required.
  • A Licensed Clinical Psychologist license is required; state-specific licensure may apply in Arizona, Florida, Georgia, Nevada, South Carolina, North Carolina, and Washington.

Responsibilities

  • Serve as a liaison for external groups and providers regarding clinical information from Operations and Medical Management teams.
  • Assess and review member clinical records and services related to behavioral health and substance use.
  • Interpret and present program results, and develop data-driven analyses and metrics to measure the effectiveness and return on investment of current and new programs.
  • Partner with staff and internal and external departments on provider education and outreach, identify gaps, and develop and deploy education efforts.
  • Partner with regional leadership for providers requiring clinical interpretation of results related to health plan reporting, data, and quality incentive payments, and facilitate discussions to make recommendations.
  • Implement and manage procedures for tracking, identifying, and resolving operational issues, including issues between the provider network, community, and facility, and make recommendations to solve them.
  • Act as the clinical representative in meetings.
  • Collaborate with staff to identify internal and external opportunities and initiate process changes to increase quality and improve staff, provider, and member satisfaction.
  • Serve as a resource and liaison for utilization, quality improvement, and case management activities.
  • Comply with all policies and standards.

About the Company

Centene

Runs government-backed health insurance plans

Centene runs government-backed health insurance plans in the United States, with Medicaid as its largest business alongside Medicare and Affordable Care Act Marketplace coverage. It is one of the largest Medicaid insurers in the country and also runs plans for people eligible for both Medicare and Medicaid, long-term care and children in foster care. States and the federal government pay Centene a set amount per member to manage care, and individuals buy its Ambetter Marketplace plans, often with federal subsidies. Centene contracts with local doctors, hospitals and pharmacies and keeps the difference between premiums and the cost of care. The company was founded in 1984 in Milwaukee and is headquartered in Clayton, Missouri.

Company size
10,001+
Company stage
IPO
Headquarters
Clayton, MO
Founded
1984

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