Quality Behavioral Health Advocate

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

📋 Description

• Collaborate with members and providers to address gaps in behavioral health care and eliminate barriers to access.

• Enhance member and provider experience through focused outreach initiatives.

• Work alongside members and providers to improve behavioral health HEDIS metrics.

• Support quality improvement initiatives in behavioral health.

• Conduct outreach via phone, providing education and health coaching.

• Schedule medical appointments and follow-ups.

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

• Serve as a liaison and advocate for members and their families, physicians, and agencies.

• Directly address FUH, FUM, and FUA HEDIS care gaps.

• Assist members in locating and engaging with behavioral health providers.

• Maintain documentation of member interactions and actions taken.

• Collaborate with customer service and other departments to resolve member issues.

• Refer members to case management or disease management services as needed.

• Provide coaching and training to Quality Behavioral Health Advocates.

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

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

• Assist with the development of new and expanding healthcare quality improvement and HEDIS initiatives.

• Represent the supervisor in meetings and special assignments.

• Identify process improvements and support the implementation of departmental changes.

• Perform audits and chart reviews of fellow advocates' work.

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

• Complete special assignments and other duties as required.

⛳️ Requirements

• Candidates must be residents of the state of FL.

• Active FL mental health/behavioral health licensure or RN with experience in behavioral health is required.

• Bachelor’s Degree in Healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or a related field, or equivalent professional experience.

• A minimum of 4 years of relevant experience is required for this role.

• At least 4 years of experience in direct patient care, social work, quality improvement, or health coaching, ideally within a managed care setting.

• Required upon hire: one of the following credentials - LCSW, LMSW, Licensed Psychologist, RN-BC, PMHNP-BC, MFT, LMFT, LMHP, LPC, LMHC, PA-C with behavioral health experience, MD psychiatrist, LISW, LICSW, LCPC, LIMHP, LPCC, or LPCMH.

• Availability to work Monday through Friday, 8 am to 5 pm Eastern Time.

• Ability to maintain the confidentiality of business and protected health information.

• Adherence to all policies and standards is mandatory.

🏝️ Benefits

• Health insurance coverage.

• 401K retirement plan.

• Opportunities for stock purchase.

• Tuition reimbursement program.

• Paid time off in addition to holidays.

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

• Competitive salary.

• Additional incentives may be included in the overall compensation package.

• Equal opportunity employer dedicated to promoting diversity.