Position: Social Services Clinical Liaison - Population Health Management
Length: Contract through EOY 2025 with potential for extension & conversion to full-time
Location: 100% Remote
Start Date: ASAP
GENERAL SUMMARY:
The Population Health Management Social Services Clinical Liaison will report to the Director of Social Services, Medi-Cal Population Health Management. The Population Health Management Social Services Clinical Liaison interfaces with both DHCS and California health plans; External Local Government Agencies and Providers including, but not limited to: County Child Welfare, County Behavioral Health and Enhanced Care Management (ECM) Providers; and, internal Medi-Cal health plan staff including Population Health Management Care Management and Social Services staff, and ECM Program Management staff. The Population Health Management Social Services Clinical Liaison will serve as the primary point of contact to identify and resolve escalated Member-case specific, systematic, and operational obstacles for accessing services while providing programmatic support across Social Services program areas.
Responsibilities:
Supports the Population Health Management Social Services Leadership Team in setting goals, providing direction, and supporting implementation of clinical initiatives with strategic partners in alignment with APL 23-029 Memorandum of Understanding for Medi-Cal Managed Care Plans and Third-Party Agencies.
- Serves as a point of contact for internal and external staff and stakeholders to resolve escalated issues in a timely manner when Members experience difficulty accessing services, obtaining referrals, changing Providers, or facing operational obstacles to receiving health care services
- Provides resources and support regarding Medi-Cal Health Plan Member enrollment and disenrollment, when applicable.
- Assists with benefits and services navigation and coordination throughout the Medi-Cal Health Plans service area to provide full-spectrum services to Members, including but not limited to: ECM, Community Supports, Behavioral Health, Transitional Care Services, Health Education, Home and Community Based Services, California Childrens Services (CCS), Tribal health care, and other local service area resources
- Collaborates with the internal ECM Program Management team and Medi-Cal Health Plan contracted ECM providers to: ensure effective referral pathways exist for all Members eligible for ECM services; maintain collaborative working relationships; and, implement continuous quality improvement activities across the program.
- Attends quarterly meetings with local County agencies to address care coordination, quality improvement activities, quality improvement outcomes, systemic and case-specific concerns.
- Participates in and provides input for quality improvement activities associated with established MOUs between the client and County agencies.
- Collaborates with the Medi-Cal Health Plan County Liaison to ensure compliance with the training and education provisions of established MOUs.
- Enhances relationships between Medi-Cal Health Plan and County agencies through participation in the MCP Community Advisory Committee and other MCP committees and meetings, including collaboration with other MCP Liaisons (internally and in other MCPs).
Requirements:
- Requires a Master's degree in a Social Work or equivalent field
- Requires current, active California Board of Behavioral Sciences (BBS) license: LCSW, LMFT, LPCC
- Requires at least 10 years of prior relevant experience
- 3+ years of Medi-Cal (Medicaid) experience, including knowledge of benefits and applicable resources including enrollment and disenrollment processes
- 3+ years experience, expertise, or training in child welfare services, County behavioral health services, County care coordination and assessment processes, and trauma-informed care practices.
- 3+ years experience in consulting, project management, data analytics, operations, or a related field
- Excellent verbal and written communication style, coupled with strong data analytics skills, to drive positive outcomes
- Resourceful and collaborative: team collaborator with strong listening skills, emotional intelligence and the ability to offer creative solutions to drive consensus
Preferred:
- 3+ years experience working with advanced Excel functions (formulas, pivot tables, vlookup, macros, etc..)