Quality Behavioral Health Advocate

This is a fully remote position, open to applicants in Florida.

📋 Description

• Collaborate with members and providers to bridge gaps in behavioral health care and eliminate obstacles to access.

• Enhance the experience of members and providers through focused outreach initiatives.

• Partner with members and providers to advance behavioral health HEDIS metrics.

• Support initiatives aimed at improving the quality of behavioral health care.

• Conduct outreach via telephone to Medicaid members who have recently been discharged from the Emergency Room/ED.

• Offer education and health coaching to members and their families about recognized care gaps.

• Arrange doctor appointments and follow-up consultations.

• Organize transportation and connect members with community resources and affinity programs.

• Serve as a liaison and advocate for members and families, engaging with physicians, facilities, and agencies.

• Record all interactions with members and the actions taken.

• Collaborate with other departments, including customer service, to address member concerns.

• Refer members to case or disease management as necessary.

• Provide coaching and training to Quality Behavioral Health Advocates.

• Act as a subject matter expert on departmental best practices, reporting, and data extraction.

• Lead the development and submission of projects, reports, and assignments.

• Assist in the rollout of new and ongoing healthcare quality improvement and HEDIS initiatives.

• Represent the supervisor in meetings and special assignments.

• Contribute to the establishment of process improvements and the implementation of departmental changes.

• Conduct audits and chart reviews of fellow Quality Behavioral Health Advocates.

• Participate in community, health department, collaborative, and organizational quality improvement meetings.

• Adhere to all policies and standards.

• Perform other duties as assigned.

⛳️ Requirements

• Candidates must reside in the state of Florida.

• Active, current, and unrestricted licensure as LCSW, LMFT, LMHC, or LPC is required.

• A Master's degree in Behavioral Health or Social Work, or a degree from an accredited nursing school is necessary.

• 2–4 years of relevant experience is required.

• Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN is needed based on state contract requirements, along with behavioral health experience.

• Familiarity with behavioral health care gaps, HEDIS measures, quality improvement, and regulatory/contractual obligations is essential.

• Capability to perform telephonic outreach, education, health coaching, audits, and chart reviews.

• Must be able to maintain the confidentiality of business and protected health information.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement program.

• Paid time off along with holidays.

• Flexible work arrangements including remote, hybrid, field, or office schedules.

• Additional incentives may be included in total compensation.

• Equal opportunity employer dedicated to diversity.