Sorry, this job is no longer accepting applications. See below for more jobs that match what you’re looking for!

Clinical Liaison

Expired Job

Aetna Inc. Richmond , VA 23234

Posted 2 months ago

Job Description:


The BH Clinical Liaison/BH Coordinator 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. They represent the plan and collaborate with State governments, key stakeholders, community organizations, advocacy groups as well as the Medicaid Plans Chief Medical Officer and leadership team to enhance the quality of services provided to Aetna members and to ensure adherence to performance targets of the business area.

Fundamental Components:

  • 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, 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 plan's 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.

  • Participates/supports process improvement initiatives within care management and across broader Plan operations.


  • Minimum 5+ years' experience required working for a managed care organization (MCO).
  • Minimum 5+ years clinical experience, clinical and program oversight experience required, preferably in behavioral health, mental health, psychiatric care. Proficiency with MS Office Suite, WORD, Excel, Outlook, etc. and strong keyboard navigation skills are required. Experience with delivery/supervision of community based Medicaid behavioral health services strongly preferred


The highest level of education desired for candidates in this position is a Master's degree or Bachelor's degree (Registered Nurses) or equivalent experience.


Nursing/Registered Nurse is required or

Mental Health/Licensed Clinical Social Worker is required or

Mental Health/Licensed Independent Social Worker is required or

Mental Health/Licensed Professional Counselor is required



  • Medical Management/Medical Management

  • Case Management/4-6 Years


  • Medical Management/Medical Management

  • Managed Care/Insurance Administration/4-6 Years


  • 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. One of the following licenses is required:

  • Licensed and masters prepared behavioral health clinician; i.e., Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC) Strongly preferred.

  • Licensed Professional Counselor (LPC) or

  • Registered Nurse (RN); BSN with strong psych background required.

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.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Aetna takes our candidates's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Clinical Liaison


Posted 2 months ago

VIEW JOBS 10/8/2018 12:00:00 AM 2019-01-06T00:00 Are you ready for a challenging, highly visible and rewarding position? Are you an experienced clinician with a passion for business development? Would you like to work for one of "America's 100 Best Hospitals for Orthopedic Surgery™ and Joint Replacement?" Then come join our team! Parham Doctors' Hospital is a 200-bed acute-care facility serving Central Virginia. As part of the Hospital Corporation of America (HCA) family our hospital offers orthopedics, spine surgery, bariatric surgery, behavioral health care, inpatient rehabilitation, emergency services, podiatry, sleep services, primary care, an occupational health and travel clinic, and outpatient surgery. Parham Doctors' Hospital has been recognized by Healthgrades as America's 100 Best Hospitals for Orthopedic Surgery™ and Joint Replacement Awards™. These distinctions put Parham Doctors' Hospital in the top 5% of more than 4,500 hospitals nationwide. In this pivotal role the Clinical Liaison will assume a leadership position, developing relationships with case managers, physicians, and clinicians in acute care and other sub-acute environments. You'll also educate staff, patients and families regarding Parham Doctors' Hospital's top notch rehabilitation services in an effort to identify patients that need/qualify for in-patient rehab as well as drive referrals and admissions. If you are professional with great interpersonal skills, analytical, proactive, results driven, and looking for a change from day to day bedside care this Clinical Liaison role may be for you! The responsibilities of the Clinical Liaison include but are not limited to: * Assist and coordinates the in-take and pre-admission screening process. Accurately documents evidence of rehab admission criteria on Pre-Screen evaluation in a timely and legible manner. * Perform on-site and off-site clinical evaluation to assist Rehab Medical Director in determining appropriateness of patient for admission. * The Clinical Liaison communicates to patients and referral sources the expectations and requirements for participation upon admission to the rehab program. Secures information relating to patients resources and healthcare insurance benefits. * Demonstrates clinical knowledge of rehab admission criteria, leading to appropriate identification of qualified rehab patients. * Functions as primary contact for case management and referring physicians. Establishes and maintains effective working relationships with the same referral sources. * Completes face-to-face, in-service educational contacts with physicians, case managers, other interdisciplinary members and other professionals. Serves as an educational resource to patients, family members and caregivers. * The Clinical Liaison assists in developing the annual strategic plan for the Rehab Unit/Hospital, to include visible community outreach programming and raising community awareness of services available. Required Clinical Licensures acceptable for this position: –Registered Nurse (CRRN a plus) –Physical Therapist –Occupational Therapist –Speech Language Pathologist * Minimum 2 years clinical experience required (5 years preferred) * At least 1 year of sales/business development experience preferred. * Clinical experience in the care and management of the Inpatient Rehabilitation patient preferred * Experience as a clinical liaison coordinating admissions for inpatient rehabilitation preferred. * Not a bonus eligible position * May require PRN and Weekend rotation HCA Richmond VA

Clinical Liaison

Expired Job

Aetna Inc.