Behavioral Health Program Consultant (Apply in minutes)
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You could be the one who changes everything for our 28 million members as aclinical professional on our Medical ManagementHealth Services team. Centeneis a diversified, national organization offering competitive benefitsincluding a fresh perspective on workplace flexibility.**Position Purpose:** Serve as a liaison for external groups and providersregarding clinical information from the Operations and Medical Managementteams. Assesses and performs review of member clinical records and servicesrelated to behavioral health and substance use.* Interpret and present program results and develop data-driven analysis and metrics used to measure effectiveness and ROI of all current and new programs* Partner with various staff, along with internal and external departments on provider education and outreach; determine where there are gaps and work to develop and deploy education efforts* Partner with regional leadership for providers requiring a clinical interpretation of results related to health plan reporting, data and quality incentive payments; facilitate discussions to make recommendations* Implement and manage procedures for tracking, identifying and problem-solving operational issues, including issues between the provider network, community, and the facility, and make recommendations to solve* Act as the clinical representative in various meetings* Collaborate with staff to identify internal and external opportunities and initiate process changes to increase quality and improve staff, provider and member satisfaction* Serve as resource and liaison on utilization, quality improvement and case management activities* For NH Health Plan Only: Perform Behavior Health provider audits and technical assistance activities. Track and monitor outcomes and opportunities for improvement. Participate with the BH program functions and operations. Participate in exhibit O or any additional reporting requirements. Local travel required for in-person events, projects, auditing and community engagement activities* Performs other duties as assigned* Complies with all policies and standards_***This is a remote position available for candidates nationwide. The idealcandidate will have 4 years of post licensure experience, bilingual (Spanishspeaking) with Florida license and experience in an outpatient behavioralhealth setting, experience working in provider facing positions with knowledgeor experience in managed care settings, treatment planning, assessments, andwork in managed care settings with SMI (Serious Mental Illness) population.**_**EducationExperience:** Master's degree in Social Work or Behavioral Healthor Graduate from an Accredited School of Nursing. 4-6 years related experienceproviding behavioral health outpatient care in a community setting orindependent practice. Experience with assessment of treatment plans related tomental health and substance abuse across the continuum of care. Experiencewith managed care, case management, utilization management, or qualityimprovement.**LicenseCertification:** LCSW - Licensed Clinical Social Worker required orLMHC-Licensed Mental Health Counselor required orLPC-Licensed Professional Counselor required orLicensed Marital and Family Therapist (LMFT) required orLicensed Mental Health Professional (LMHP) required orRN - Registered Nurse - State Licensure andor Compact State LicensurerequiredPay Range: $67,400.00 - $121,300.00 per yearCentene offers a comprehensive benefits package including: competitive pay,health insurance, 401K and stock purchase plans, tuition reimbursement, paidtime off plus holidays, and a flexible approach to work with remote, hybrid,field or office work schedules. Actual pay will be adjusted based on anindividuals skills, experience, education, and other job-related factorspermitted by law. Total compensation may also include additional forms ofincentives.Centene is an equal opportunity employer that is committed to diversity, andvalues the ways in which we are different. All qualified applicants willreceive consideration for employment without regard to race, color, religion,sex, sexual orientation, gender identity, national origin, disability, veteranstatus, or other characteristic protected by applicable law.Qualified applicants with arrest or conviction records will be considered inaccordance with the LA County Ordinance and the California Fair Chance Act