Behavioral Health Clinical Liaison, Charlottesville/Western Region - VA - Remote

About the position

The Behavioral Health Clinical Liaison is a pivotal clinical leader within the Medicaid plan, primarily focusing on utilization management and the integration of member care. This role is essential for ensuring that Aetna members receive high-quality behavioral health services. The position requires the individual to reside in the Charlottesville/Western Region of Virginia, specifically in one of the designated counties. The Clinical Liaison will be responsible for leading the development, implementation, and ongoing monitoring of various program and quality initiatives tailored to meet the needs of Aetna members. In this role, the Clinical Liaison will manage non-traditional mental health services and addiction recovery through the utilization management process. They will drive collaboration on quality of care, utilization management, and care coordination to ensure optimal outcomes for members. The position involves outreach to high utilizers to support treatment coordination and appropriate discharge planning. As a subject matter expert in behavioral health, the Clinical Liaison will support care management staff and interface with community stakeholders to foster collaboration and provide necessary education and training. The Clinical Liaison will also consult with executive management regarding clinical issues related to medical management and will represent the plan to external stakeholders, providers, and advocacy groups. Participation in interdisciplinary case rounds is expected to address the needs of members with complex clinical presentations, and the Clinical Liaison will work with the clinical leadership team to enhance the effectiveness of these rounds. This position requires a deep understanding of biomedical, clinical, epidemiologic, and social-behavioral sciences and their application to member care, as well as participation in process improvement initiatives within care management and broader plan operations.

Responsibilities
? Clinically manage non-traditional mental health services and addiction recovery and treatment services through the utilization management process.
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? Drive collaboration on quality of care, utilization management, disparities, and care coordination to ensure optimal member outcomes.
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? Outreach to high utilizers to support treatment coordination, transitions of care, and appropriate discharge planning.
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? Serve as the behavioral health subject matter expert to support care management staff in serving Aetna members in the respective region.
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? Interface with community stakeholders to foster collaboration and provide education and training.
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? Consult with Plan executive management regarding physical and behavioral health clinical issues as they relate to medical management.
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? Support and encourage CM and UM staff to function as an interdisciplinary team, with requisite range and depth of subject matter expertise.
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? Represent Plan to relevant external stakeholders, providers/vendors, and advocacy groups regarding quality improvement initiatives and innovative care strategies.
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? Participate in interdisciplinary case rounds to address the needs of members with complex clinical presentations and identify opportunities for improvement.
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? Demonstrate knowledge about established and evolving biomedical, clinical, epidemiologic, and social-behavioral sciences and apply this knowledge to member care.

Requirements
? Must reside within the Charlottesville/Western Region of Virginia.
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? One of the following licenses in the state of Virginia is required: LPC, LCSW, LMFT, BCBA, LBA, or an RN with 5+ years of behavioral health experience.
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? 2+ years experience with delivery of community-based Medicaid behavioral health services.
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? 5+ years clinical experience in behavioral health, mental health, psychiatric care.
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? 2+ years' experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.).

Nice-to-haves
? Experience in completing utilization management tasks.
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? Demonstrated leadership competency and strong relationship builder; self-motivated and confident making decisions.
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? Ability to influence and shape clinical outcomes, a strong clinical consultant.
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? Demonstrated ability to communicate effectively with all levels of management, including senior leadership.
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? Ability to work independently.
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? 2+ years experience required working for a managed care organization (MCO).

Benefits
? Full range of medical, dental, and vision benefits.
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? 401(k) retirement savings plan.
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? Employee Stock Purchase Plan available for eligible employees.
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? Fully-paid term life insurance plan for eligible employees.
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? Short-term and long-term disability benefits.
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? Numerous well-being programs.
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? Education assistance and free development courses.
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? CVS store discount and discount programs with participating partners.
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? Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year.