Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Mission of the position:

The BH Clinical Liaison is a Behavioral Health leader for the Aetna state Medicaid plan. This may include substance use disorder (SUDS), Applied Behavioral Analysis (ABA), Trauma Informed Care, Person Centered Services, and more as dictated by the business needs of the plan. The incumbent functions as the Behavioral Health Subject Matter Expert (SME) for the plan and works across various departments including Care Management, Utilization Management, Quality Management, and Medical Management on issues related to Behavioral Health. Further, the incumbent functions as the Behavioral Health SME for departments such as Member Services, Provider Relations, Network, and Provider Credentialing. This role in the ABHFL plan will focus heavily on the Medicaid Serious Mental Illness (SMI) sub-population.Overview:

• Accountable for development, implementation, and ongoing management of complex medical management and clinical operations programs and projects
• Design conceptual models, initiative planning, business results, stakeholder relationship management and satisfaction for small to moderate scale projects and complex high value initiatives
• Responsible for providing guidance and direction to internal and external stakeholders and/or matrixed staff as required to support initiatives
• Accountable for transferring clinical and operational knowledge, best practices, and methodologies
• Awareness and tracking of state trends including the FL legislative- Develops and executes franchise model policies, procedures, workflows, training materials as needed and modifies to incorporate contract/regulatory requirements for state stakeholders and to meet accreditation needs
• Focus on the SMI FL Membership to ensure effective processes, workflows, and programming promote integrative care coordination and improve health outcomes
• Responsibility for designing and implementing innovative programs & initiatives to reduce IP Admits and Re-admits
• Responsible for monitoring, tracking, and decreasing total cost of care for FL Medicaid High Utilizers
• Collaborate and partner with multiple functional areas (Utilization Management, Care Management, Quality, etc) to ensure delivery of high-quality care management solution to the FL Medicaid SMI
• Form and maintain strong relationships with FL Community Based Organizations (CBOs) and providers who provide services to the FL Medicaid SMI population to improve services to the vulnerable sub-populations
• Aligns with contractual responsibility to build and maintain collaborative relationships with the other FL Medicaid managing entities and community stakeholders
• Responsible for understanding the FL Crisis Continuum of Care and optimizing ABHFL Medicaid members engagement with the Crisis continuum including post-crisis intervention
• Work closely with FL inpatient BH facilities to promote holistic, comprehensive discharge planning and effective transitions of care between levels of care
• Accountable for improving care management, care coordination, and overall health outcomes for ABHFL Medicaid members including children and adolescents
• Work closely with the ABHFL Network team and local FL BH providers to design, implement, and monitor effectiveness of Value Based Contracts
• Work collaboratively with internal and external teams to build knowledge an improve processes
• Group facilitation/presentation skills that inform and influence internal and external parties
• Experience in successfully building, maintaining, and supporting effective relationship across cross-functional teams to achieve goals
• Ability to manage multiple timelines and produce evidence of driving toward success with regular updates on progress in all areas of clinical project or program management
• Participate in strategic projects and process improvements based on lessons learned
• Profound understanding of clinical workflows and best practices
• Ability to effectively manage client expectations and inspire confidence
• Demonstrated experience in managing large and complex clinical initiatives and projects
• Proven communication skills both written and verbal; able to communicate effectively with all levels of the enterprise
• Work collaboratively with internal and external teams to build knowledge and improve processes; experience in successfully building, maintaining, and supporting effective relationships across cross-functional teams to achieve goals
• Group facilitation/presentation skills that inform and influence internal and external parties

• Unencumbered Licensed Mental Health Clinician in FL (LPC, LCSW, LMHC, or LCP)
• 4+ years' experience in managing healthcare initiatives and projects or clinical project program management
• 5+ years' experience working with the FL Medicaid system
• 5+ years' experience working with individuals with Serious Mental Illness (SMI)
• 5+ years' behavioral health experience
• Willing and able to travel up to 20% of their time within Miami and surrounding areas for stakeholder meetings and provider relations

• Bilingual in Spanish
• Experience in providing or monitoring behavioral health care management services to include assessments, care planning, interventions, monitoring, reporting
• Experience communicating and presenting to C-Suite executives to front-line staff and internal/external parties
• Group facilitation/presentation skills

• Masters degree in Behavioral/Mental health field required