Behavioral Health Clinical Liaison - KY SKY

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Position Summary

This position is a remote opportunity in Kentucky with 10-15% travel within the state for stakeholder meetings and trainings. The schedule is Monday-Friday, 8am-5pm EST.

Establishes and maintains relationships with various stakeholders, including healthcare facilities, physicians, discharge planners, case managers, and other referral sources.
 

Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and

education for members through the use of care management tools and resources.

Responsibilities

Evaluation of Members:

Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.

Coordinates and implements assigned care plan activities and monitors care plan progress.

Enhancement of Medical Appropriateness and Quality of Care:

Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.

Identifies and escalates quality of care issues through established channels.

Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.

Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.

Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.

Helps member actively and knowledgably participate with their provider in healthcare decision-making.

Monitoring, Evaluation and Documentation of Care:

Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Required Qualifications

• Must reside in KY
• Unrestricted Independent Licensed Behavioral Health Clinician in KY (LCSW, LPCC, LMFT, or Psychologist) or RN with current unrestricted KY state licensure
• 3+ years' experience of experience working with children in a behavioral health or social services setting
• 3+ years' experience with complex case management
• 5+ years' experience in behavioral health, social services or appropriate related field equivalent to program focus
• 3+ years' experience in handling mental health and psychiatric care, family situations, relationship concerns
• 3+ years' experience with third party relationships, including local community building efforts, governmental and regulatory authorities

Preferred Qualifications

• Case Management in a managed care environment in a community or institutional setting
• Managed Care experience
• Experience working with the Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavioral Health Services, Trauma-informed Care, ACEs, Crisis Intervention services, and evidence-based practices applicable to the Kentucky SKY populations

Education

• PhD or Psy.D for Psychologist
• Master’s degree in Social Work or Behavioral Health field for BH licensure
• Minimum BSN for RN licensure

Pay Range

The typical pay range for this role is:

$72,306.00 - $155,736.00

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