Job Details

Member Liaison Specialist Behavioral Health

Company name

Orange, CA, United States

Employment Type

Account Management, Healthcare

Posted on
Nov 22, 2021

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Member Liaison Specialist (Behavioral Health)


Job Description
Department(s): Behavioral Health Integration
Reports to: Supervisor, Behavioral Health
FLSA status: Non-Exempt
Salary Grade: C - $19.7115 - $25.4808 ($41,000 - $53,000)

Job Summary

The incumbent is responsible for assisting Medi-Cal, One Care, and One Care Connect members with behavioral health care management needs in a call center environment, which includes, but is not limited to, securing behavioral health appointments for members, following up with members before and after the initial appointment, providing members with information and referring to community resources, and assisting member in navigating the behavioral health system of care. In this role, the Member Liaison Specialist will act as a consultative liaison to assist members, CalOptima Behavioral Health providers, health networks, and community agencies to coordinate Behavioral Health services. The incumbent will also participate in various CalOptima Behavioral Health initiatives and projects in support of the Behavioral Health Integration Department.

Position Responsibilities:



  • Provides members with short-term care management support and securing Behavioral Health services appointments.
  • Coordinates members' behavioral health needs both within and outside CalOptima to ensure the coordination of member's care.
  • Collaborates and communicates with the member and/or caregiver and CalOptima Behavioral Health network providers to support successful linkage to Behavioral Health services.
  • Develops and maintains a network of current community resources and services where members can be referred to for assistance.
  • Maintains documentation of member cases within the Medical Management System.
  • Initiates referrals to both internal and external care management departments, and other government agencies. Outreaches to members and/or providers regarding new and/or ongoing CalOptima Behavioral Health initiatives such as Interdisciplinary Care Team (ICT) and Health Homes Program (HHP) participation.
  • Manages CalOptima Behavioral Health projects such as the Provider Search Tool to identify network provider availability and specialties, County Step Downs to coordinate care for members transitioning from Orange County Behavioral Health to CalOptima Behavioral Health providers and Letter of Agreement requests to assist members with continuity of care.
  • Other projects and duties as assigned.



Possesses the Ability To:





  • Develop rapport, establish, and maintain effective interpersonal relationships with internal and external contacts at all levels.
  • Adhere to CalOptima policies/procedures (i.e., Protected Health Information (PHI)/ Health Insurance Portability and Accountability Act (HIPAA).
  • Create/innovate approaches to challenges and opportunities.
  • Maintain accurate records and adhere to documentation standards.
  • Work with appropriate departments to expedite the resolution of member concerns.
  • Establish and maintain effective working relationships with CalOptima leadership and staff.
  • Communicate clearly and concisely, both verbally and in writing, with individuals from varying cultures and ethnic backgrounds.
  • Utilize and access computer and appropriate software (e.g., Microsoft: Word, Excel, PowerPoint) and job-specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position.


Experience & Education:




  • High School diploma or equivalent required.
  • 2 years of experience in Behavioral Health, Customer Service, Community Service, or other Social Service setting required.
  • Have access to an approved means of transportation for work away from the primary office approximately 5% of the time.


Preferred Qualifications:




  • Bachelor's degree in Behavioral Health or related field is preferred.
  • Health Maintenance Organization (HMO), Medi-Cal, Medicare, and Health Services experience is preferred.
  • Bilingual in English and in one of CalOptima's defined threshold languages (Spanish, Vietnamese, Arabic, Farsi, Korean, and Chinese) is preferred.


Knowledge of:




  • Available health plans and CalOptima's benefit structure.
  • Issues that face members with Behavioral Health needs.
  • Principles and practices of health care service delivery and managed care.
  • Principles and techniques for effective communication and education.
  • Appropriate techniques to serve the population in diverse backgrounds.
  • Appropriate methods and techniques to track and respond to service-related complaints and grievances.


CalOptima is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima wants to have qualified employees in every job position. CalOptima prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. You can request reasonable accommodations by contacting Human Resources Disability Management at 657-900-1134.

Job Location: Orange, California
Position Type:

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