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MI Duals Behavioral Health Lead - Clinical Liaison - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | kalamazoo, Michigan |
About this job
$3000 Sign on Bonus! We are seeking an experienced clinician with managed care or managed behavioral healthcare expertise.
Aetna Better Health Premier Plan, a MI Health Link Plan, is looking for caring people who share our vision of helping to provide innovative, community-based health care for dual-eligible Medicare-Medicaid members in Michigan. Aetna Better Health of Michigan is a great place to work. As an employee, not only will you be helping others, you'll be part of a team just as dedicated as you. Our company values diversity and is dedicated to helping you achieve your career goals.
POSITION SUMMARY:
Position is located in Kalamazoo. The BH Lead-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.
The BH Lead-Clinical Liaison represents the plan and collaborates with State governments, key stakeholders, community organizations, advocacy groups as well as the Chief Medical Officer and plan leadership team to enhance the quality of services provided to Aetna Medicaid members and to ensure adherence to performance targets of the business area. This position also collaborates with Prepaid Inpatient Health Plans.
FUNDAMENTAL COMPONENTS:
- Leads health plan in collaboration/coordination efforts with Prepaid Inpatient Health Plans, including oversight of delegated functions.
- Partners with Plan executive leadership team to provide overall vision and leadership across all Plan activities.
- Serves as a key resource regarding any issues related to the integration of member care across departments.
- Drives collaboration on quality of care, utilization management, disparities and care coordination to ensure optimal member outcomes.
- Partners with AETNA Community Outreach Team and Health Care Equity Director to develop strategies with key stakeholders to improve integration efforts and optional care delivery to members.
-Ensures compliance with DHH and other requirements.
- 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, physical health, behavioral health and human services system issues including critical stakeholders such as various departments of state government, provider organizations, advocacy organizations, etc.
- Partners with Aetna Medicaid's regional psychiatrist(s) to manage and oversee ICM within the health plan.
- Provides consultation to support physicians at other Medicaid Plans.
- Participates in organizational planning, including strategic plans, business plans, and new product development.
- 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 CM, UM and DM 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.
BACKGROUND/EXPERIENCE:
- Minimum 5+ years' experience required working for a managed care organization (MCO) or managed behavioral health organization (MBHO).
- Minimum 5+ years' clinical experience including program oversight experience required, preferably in behavioral health, mental health, or psychiatric care.
- 3-5 years of physical health and behavioral health integration experience with an awareness of the impact on the individual.
-Previous supervisory experience, overseeing a care management team within a managed care and/or health plan setting is required.
-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.
LICENSES AND CERTIFICATIONS:
One of the following licenses is required:
- Licensed Masters-level Behavioral Health Professional is preferred; i.e., Licensed Clinical Social Worker (LCSW) or Licensed Independent Social Worker (LISW) or Licensed Professional Counselor (LPC).
-BSN-Registered Nurse, RN candidate must possess strong behavioral health background/experience
EDUCATION:
The level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
TECHNOLOGY EXPERIENCES
Technical - Desktop Tools/Microsoft Word/4-6 Years
Technical - Desktop Tools/TE Microsoft Excel/4-6 Years
Technical - Desktop Tools/Microsoft Outlook/4-6 Years
Technical - Desktop Tools/Microsoft SharePoint/1-3 Years
ADDITIONAL JOB INFORMATION:
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Employment Type Regular Career Band Description Professional
Aetna Better Health Premier Plan, a MI Health Link Plan, is looking for caring people who share our vision of helping to provide innovative, community-based health care for dual-eligible Medicare-Medicaid members in Michigan. Aetna Better Health of Michigan is a great place to work. As an employee, not only will you be helping others, you'll be part of a team just as dedicated as you. Our company values diversity and is dedicated to helping you achieve your career goals.
POSITION SUMMARY:
Position is located in Kalamazoo. The BH Lead-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.
The BH Lead-Clinical Liaison represents the plan and collaborates with State governments, key stakeholders, community organizations, advocacy groups as well as the Chief Medical Officer and plan leadership team to enhance the quality of services provided to Aetna Medicaid members and to ensure adherence to performance targets of the business area. This position also collaborates with Prepaid Inpatient Health Plans.
FUNDAMENTAL COMPONENTS:
- Leads health plan in collaboration/coordination efforts with Prepaid Inpatient Health Plans, including oversight of delegated functions.
- Partners with Plan executive leadership team to provide overall vision and leadership across all Plan activities.
- Serves as a key resource regarding any issues related to the integration of member care across departments.
- Drives collaboration on quality of care, utilization management, disparities and care coordination to ensure optimal member outcomes.
- Partners with AETNA Community Outreach Team and Health Care Equity Director to develop strategies with key stakeholders to improve integration efforts and optional care delivery to members.
-Ensures compliance with DHH and other requirements.
- 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, physical health, behavioral health and human services system issues including critical stakeholders such as various departments of state government, provider organizations, advocacy organizations, etc.
- Partners with Aetna Medicaid's regional psychiatrist(s) to manage and oversee ICM within the health plan.
- Provides consultation to support physicians at other Medicaid Plans.
- Participates in organizational planning, including strategic plans, business plans, and new product development.
- 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 CM, UM and DM 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.
BACKGROUND/EXPERIENCE:
- Minimum 5+ years' experience required working for a managed care organization (MCO) or managed behavioral health organization (MBHO).
- Minimum 5+ years' clinical experience including program oversight experience required, preferably in behavioral health, mental health, or psychiatric care.
- 3-5 years of physical health and behavioral health integration experience with an awareness of the impact on the individual.
-Previous supervisory experience, overseeing a care management team within a managed care and/or health plan setting is required.
-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.
LICENSES AND CERTIFICATIONS:
One of the following licenses is required:
- Licensed Masters-level Behavioral Health Professional is preferred; i.e., Licensed Clinical Social Worker (LCSW) or Licensed Independent Social Worker (LISW) or Licensed Professional Counselor (LPC).
-BSN-Registered Nurse, RN candidate must possess strong behavioral health background/experience
EDUCATION:
The level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
TECHNOLOGY EXPERIENCES
Technical - Desktop Tools/Microsoft Word/4-6 Years
Technical - Desktop Tools/TE Microsoft Excel/4-6 Years
Technical - Desktop Tools/Microsoft Outlook/4-6 Years
Technical - Desktop Tools/Microsoft SharePoint/1-3 Years
ADDITIONAL JOB INFORMATION:
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Employment Type Regular Career Band Description Professional