Behavioral Health Advocate, Utilization Management - Remote
About The Position
As a Behavioral Health Advocate, you will respond to treatment requests from providers and facilities, as well as manage and deescalate crisis calls from members. You'll have a direct impact on the lives of our members as you recommend and manage the appropriate level of care throughout the entire treatment plan. This is a telephonic, queue based position responding to treatment requests and crisis calls. The schedule is Monday - Friday, 8am - 5pm CST and includes working one weekday holiday per year. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Requirements
- Licensed Master's degree in Psychology, Social Work, Counseling, or Marriage and Family Therapy; or Licensed Ph.D.
- Active, unrestricted, independent clinical licensure in state of residence (e.g., LCSW, LICSW, LMFT, LMHC LP, LPC, LPCC, etc.)
- 2+ years of experience in a related mental health setting
- Proficient in MS Office Suite, including Word, Outlook, Excel, and Teams
- Dedicated, distraction-free workspace and secure, high-speed internet at home
- Able to work Monday – Friday, 8am – 5pm CST
- Available to work one weekday holiday per calendar year
Nice To Haves
- Licensed Alcohol and Drug Counselor (LADC)
- Experience working with Substance Use Disorders (SUD)
- Experience working with children, adolescents, and families
- Experience in an inpatient setting
- Experience in a community mental health setting
- Dual diagnosis experience with mental health and substance abuse
- Experience in a managed care environment (i.e., health insurance company / managed care organization [MCO])
- Proven solid problem-solving skills
- Proven excellent customer service skills
- Proven excellent organizational skills
Responsibilities
- Work with providers, facilities, and members to perform utilization management and authorization for outpatient services
- Ensure that behavioral health care services provided are medically necessary per standard guidelines and provided in the most appropriate setting
- Assess, plan, implement, coordinate, monitor, and evaluate the options and services to meet the enrollee’s health needs using education, communication, and all available resources to promote quality, cost-effective outcomes
- Plan for discharge and manage transitions between care settings to ensure the appropriate services/resources are in place for quality outcomes
- Refer members to appropriate psychiatric and community referrals and assist with identifying and removing potential barriers
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
