Remote Behavioral Health Liaison — Quality & Utilization

Centene Corporation; Kansas City (MO); Remote; USD 70,000 - 126,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Job summary

Centene Corporation in Missouri seeks a Clinical Liaison to coordinate behavioral health and substance use information between Operations, Medical Management, and external providers. You will assess member records, review services, and support program metrics.

This remote position requires MO licensure and outpatient experience; you will partner with regional leadership and care teams to interpret results, identify gaps, and drive quality improvement and utilization management.

Qualifications

• Master's degree in Social Work or Behavioral Health required.
• 4+ years of outpatient behavioral health experience in community settings or independent practice required.
• Experience with assessment of treatment plans for mental health and substance use.

Responsibilities

• Serve as liaison for external groups and providers regarding clinical information.
• Assess and review member clinical records and services related to behavioral health and substance use.
• Interpret and present program results and develop data-driven analysis and metrics to measure effectiveness and ROI.
• Partner with staff and internal/external departments on provider education and outreach; identify gaps and develop education efforts.
• Partner with regional leadership for providers requiring clinical interpretation of results related to health plan reporting; facilitate discussions to make recommendations.
• Implement and manage procedures for tracking and solving operational issues between provider network, community, and facility; make recommendations to solve.
• Act as the clinical representative in various meetings.
• Collaborate to identify opportunities and initiate process changes to increase quality and staff/provider/member satisfaction.

Skills

Clinical liaison

Data analysis

Education outreach

Utilization management

Quality improvement

Case management

Education

Master's degree in Social Work/Behavioral Health

Job description

Centene Corporation in Missouri seeks a Clinical Liaison to coordinate behavioral health and substance use information between Operations, Medical Management, and external providers. You will assess member records, review services, and support program metrics.

This remote position requires MO licensure and outpatient experience; you will partner with regional leadership and care teams to interpret results, identify gaps, and drive quality improvement and utilization management.