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Manager Behavioral Health Clinical Liaison/Ops | RN, LCSW, BH

Amerihealth

This is a Full-time position in Newark, DE posted June 10, 2021.

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation’s leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

The Behavioral Health Clinical Liaison is clinical leader who will focus on integrating the physical and behavioral health care for members, clinical coordination, leading the development, implementation and ongoing monitoring of program and quality initiatives to address the needs of members. They represent the plan and collaborate with State governments, key stakeholders, community organizations, advocacy groups as well as the Chief Medical Officer and leadership team to enhance the quality of services provided to members and to ensure adherence to performance targets of the business area.  
In Summary, the incumbent:

  • Partners with Plan executive leadership team to provide overall vision and leadership for behavioral health and physical health integration across all Plan departments.
  • Works in consultation with department leadership in strategic direction and planning of program initiatives.
  • Serves as a key resource regarding any issues related to the integration of member care across departments.
  • Consults with Plan executive management regarding physical and behavioral health clinical issues as they relate to medical management (UM, IHCM, LTSS) provider and system of care issues, behavioral health and human services system issues including critical stakeholders such as various departments of state government, provider organizations, advocacy organizations, etc.
  • Serves as key resource for operational issues related to behavioral health services.
  • Ensure compliance with regulatory and accrediting entities related to behavioral health for the plan
  • Elicits staff input related to their job functions and leverages errors and failure to reach performance targets as opportunities for organizational learning and improvement
  • Supports and encourages IHCM, UM and LTSS, when applicable, 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, such as state government officials, providers/vendors, & advocacy groups with regard to quality improvement initiatives, integrating member care, health plan success, and innovative care strategies
  • With the plans physician leader, co-facilitates 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.
  • Participate in and support process improvement initiatives within care management and across broader Plan operations.
  • Maintain work plan to monitor and track progress of programs and activities during the year.

Education/Experience:

  • Bachelor’s Degree | Registered Nurse or Licensed Social Worker 
  • Behavioral Health Experience
  • 3-5 years experience
  • Presentation Skills
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