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Clinical Professional

2 months ago

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**Job Summary:**

We are seeking a highly skilled Clinical Liaison to join our Medical Management/Health Services team at Centene Corporation. As a clinical professional, you will play a critical role in serving as a liaison for external groups and providers regarding clinical information from our Operations and Medical Management teams.

Key Responsibilities:

  • 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
  • Perform other duties as assigned
  • Comply with all policies and standards

Requirements:

  • Masters in Social Work / Behavioral health
  • 5+ years of experience in managed care, utilization management, case management, or quality improvement
  • LPC, LCSW, LMHC or LMFT

What We Offer:

  • Competitive pay
  • Health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • A flexible approach to work with remote, hybrid, field or office work schedules