[Remote] Behavioral Health Clinical Liaison - Work at Home - Virginia at CVS Health

Virginia, Minnesota, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Medicaid, Behavioral HealthIndustries

Requirements

Must reside in Virginia
Registered Nurse with 5 years Behavioral Health Experience or Behavioral Health Licensed clinician with one of the following licenses in the state of Virginia
Reliable phone and hard-wired internet service for work at home
Ability to work Monday-Friday 8:30-5:00 PM EST, with occasional on-call weekend and holiday coverage
Must be reachable via phone, videoconference, and email during work hours (8 hours per day)
Secure and private work environment to maintain confidentiality (HIPAA compliant)
Personal responsibilities, including dependent care, must not interfere with work duties; dependent care during work hours generally not allowed
Potential for up to 10% travel in Virginia

Responsibilities

Clinically manage non-traditional mental health services and addiction recovery and treatment services through the utilization management process
Drive 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
Consult 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
Support and encourage 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
Represent 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, identify opportunities for improving rounds, and work with the clinical leadership team to optimize the value of rounds to the clinical staff
Demonstrate knowledge about established and evolving biomedical, clinical, epidemiologic and social-behavioral sciences and the application of this knowledge to member care
Participate/support process improvement initiatives within care management and across broader Plan operations

Skills

Utilization Management

Clinical Coordination

Behavioral Health

Medicaid

Quality Initiatives

Program Development

HIPAA Compliance

Care Integration

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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