Clinical Liaison - Virginia

CVS Health; United States; Remote; USD 80,000 - 174,000; Full time

Job summary

An established industry player is seeking a Behavioral Health Clinical Liaison to lead clinical initiatives within their Medicaid plan. This role focuses on integrating member care and enhancing service quality through collaboration with community partners. Candidates should possess strong clinical expertise, particularly in behavioral health, and demonstrate leadership abilities. The position offers a dynamic work environment with a commitment to improving healthcare outcomes for members. Join a team dedicated to transforming health care with compassion and innovation.

Benefits

Affordable medical plan options

401(k) plan with matching contributions

Employee stock purchase plan

No-cost wellness programs

Flexible work schedules

Tuition assistance

Paid time off

Colleague assistance programs

Dependent care resources

Retiree medical access

Qualifications

• Minimum 5+ years clinical experience in behavioral health.
• Proficiency with MS Office Suite required.
• Experience in managed care organization preferred.

Responsibilities

• Clinically manage non-traditional mental health services.
• Drive collaboration on quality of care and care coordination.
• Participate in interdisciplinary case rounds for complex clinical needs.

Skills

Behavioral Health

Clinical Coordination

Utilization Management

Analytical Skills

Communication Skills

Leadership

Education

Master's Degree

BSN (for Registered Nurses)

Tools

MS Office Suite

Job description

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.

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 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

Education
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

40

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.

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 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

Education
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

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$80,340.00 - $173,040.00

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.

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 people

We 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.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 05/31/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

About the company

At CVS Health, we share a clear purpose: helping people on their path to better health. Through our health services, plans and community pharmacists, we’re pioneering a bold new approach to total health. Making quality care more affordable, accessible, simple and seamless, to not only help people get well, but help them stay well in body, mind and spirit.