Job Description
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Must reside in Virginia. Potential for up to 10% of travel in region candidate resides. Schedule: Monday- Friday 8-5 with occasional on call holiday weekend coverage required. The BH Clinical Liaison is a clinical leader in the Medicaid plan focusing on utilization management, 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 internal partners, community organizations, and behavioral health and ARTS providers to enhance the quality of services provided to Aetna members and to ensure adherence to performance targets of the business area.
Fundamental Components:
Clinically manage non-traditional mental health services and addiction recovery and treatment services through the utilization management process
Drives collaboration on quality of care, utilization management, disparities and care coordination to ensure optimal member outcomes.
Outreach to high utilizers to support treatment coordination, transitions of care, and appropriate discharge planning
Serve as the behavioral health subject matter expert to support care management staff in serving Aetna members in the respective region
Interface with community stakeholders to foster collaboration and provide education and training
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
Supports and encourages CM and UM 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, providers/vendors, & advocacy groups with regard to quality improvement initiatives, integrating member care, health plan success, and innovative care strategies.
Participate in 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.
Required:
Must reside within the Virginia.
One of the following licenses in the state of Virginia is required: LPC, LCSW, LMFT, BCBA, LBA, or an RN with 5+ years of behavioral health experience
2+ years experience with delivery of community-based Medicaid behavioral health services
5+ years clinical experience in behavioral health, mental health, psychiatric care
2+ years' experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.)
Preferred Experience:
Experience in completing utilization management tasks
Demonstrated leadership competency and strong relationship builder; self-motivated and confident making decisions
Ability to influence and shape clinical outcomes, a strong clinical consultant
Demonstrated ability to communicate effectively with all levels of management, including senior leadership.
Ability to work independently
2+ years experience required working for a managed care organization (MCO).
EDUCATION
If an LPC, LCSW, LMFT, BCBA, LBA, a Master's degree in behavioral health field is required
If an RN, Associate's degree is required
Anticipated Weekly Hours 40
Time Type Full time
Pay Range The typical pay range for this role is:
$80,340.00 - $173,040.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit
We anticipate the application window for this opening will close on: 08/11/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Job Tags
Hourly pay, Full time, Temporary work, Local area, Flexible hours, Monday to Friday,