Behavioral Health Coordinator / Clinical Liaison

AmeriHealth Caritas

Concord, NH

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JOB DETAILS

SKILLS

Administrative Skills, Behavioral Health, Biotech and Pharmaceutical, Community Health, Compensation and Benefits, Conferences, Diversity, Government, Health Informatics, Health Plan, Health Plan Membership, Healthcare, Healthcare Management, Healthcare Providers, Healthcare Quality, Managed Care, Medicaid, Operational Audit, Organizational Skills, Pharmacy, Problem Solving Skills, Product Management, Regulations, Regulatory Reports, Regulatory Requirements, Reporting Skills, Social Work, Treatment Plan

LOCATION

Concord, NH

POSTED

1 day ago

Position Summary:

Under the supervision of the Integrated Healthcare Management Manager, theBehavioral Health Coordinator/Clinical Liaisonis responsible for identifying, assessing, planning, coordinating, and implementing appropriate, cost-effective, and quality healthcare services for individuals requiring additional assistance in accessing behavioral health services. Acts as a liaison between the Health Plan and regulatory agencies. Works collaboratively with all Health Plan departments and providers to facilitate cost-effective care and improve member outcomes.

Essential Responsibilities

Acts as a liaison between regulatory agencies, the Health Plan, behavioral health members, caregivers, healthcare providers, and payors.

Investigates and assists in the resolution of issues referred to the Health Plan from the Medicaid agency including, but not limited to, pharmacy, claims, member appeals, medical and dental provider network issues, care delivery, access to care, expedited enrollment, and residential and long-term placement for behavioral health members.

Participates in meetings, conference calls, and case discussions with government agencies and/or providers including, but not limited to, on-site Behavioral Health Monitoring meetings, Joint Treatment Plan Conferences, PH-MCO/BH-MCO meetings, Juvenile Court Services, and Integrated Health Homes (IHH).

Collaborates with Statutory Reporting and Medical Informatics in the preparation and review of monthly Behavioral Health reports. Provides monthly reports and analysis of operations and services as required by departmental guidelines and regulatory requirements.

Functions as a liaison with community organizations and healthcare providers. Supports and assists providers and advocates for behavioral health members in resolving questions regarding access to covered care and services.

Supports IHCM staff as they work with members, caregivers, PCPs, specialists, and providers to resolve issues affecting individual members or behavioral health populations. Monitors and coordinates reporting and resolution of issues to the Medicaid agency or other responsible government agencies.

Performs other duties and projects as assigned.

Work Arrangement: Remote – Anywhere within the State of New Hampshire.

Education and Experience:

Bachelor’s Degree required.

Registered Nurse (RN) required.

+ Licensed Social Worker (LSW) preferred.

+ Knowledge of systems and resources in New Hampshire preferred

3 years of experience working with behavioral health and/or Medicaid populations. 5+ years is strongly preferred.

5 years of clinical nursing or behavioral health experience.

Our Comprehensive Benefits Package

Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents starting Day 1, 401(k) retirement savings plan, tuition reimbursement, and more.

Why Join Us: Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare 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 are driven to make a difference, we want to hear from you.

About AmeriHealth Caritas

Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. Our services include integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at http://www.amerihealthcaritas.com
As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

About the Company

AmeriHealth Caritas

Leaders in health care solutions for those most in need

AmeriHealth Caritas is the nation's leader in providing comprehensive health care solutions for those in most need and the chronically ill. We impact the lives of more than 5.7 million members nationwide. With more than 30 years of experience managing care for individuals and families in publicly-funded programs, we have become known for developing innovative solutions that help improve health outcomes while reducing costs.

Our mission, our goal

Our mission is to help people get care, stay well and build healthy communities. Our goal is to provide responsible managed care solutions, including Medicaid, Medicare, and CHIP - plus behavioral health, pharmacy benefits management and third-party management and administrative services.

COMPANY SIZE

5,000 to 9,999 employees

INDUSTRY

Healthcare Services

FOUNDED

1985

WEBSITE

http://www.amerihealthcaritas.com

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