Quality Behavioral Health Advocate
Core
Works with members and providers to close behavioral health care gaps, remove barriers to care, and improve member/provider experience through targeted outreach and quality improvement initiatives.
Role type
Senior IC behavioral health advocate (care gap closure)
Builds
Behavioral health care access and quality improvement outcomes for Medicaid members
Domain
Healthcare + Behavioral Health
Required skills
Behavioral health counseling, care gap identification, telephonic outreach, appointment scheduling, care coordination, transportation arrangement, community resource connection, HEDIS compliance, audit/chart review, process improvement
Preferred skills
Master's degree in Behavioral Health or Social Work, 2-4 years related experience, active unrestricted LCSW/LMFT/LMHC/LPC licensure, RN licensure with BH experience
Technologies
HEDIS metrics, telephonic platforms, case management systems
Responsibilities
Conduct telephonic outreach to members identified as needing behavioral health services; Schedule doctor appointments and arrange follow-up visits; Provide education to members and families regarding care gaps and barriers; Arrange transportation and connect members with community-based resources; Close FUH, FUM, and FUA HEDIS care gaps; Conduct audits and chart reviews on fellow advocates; Assist with implementation of new QI/HEDIS initiatives; Act as subject matter expert for departmental best practices and data extracts; Represent supervisor in meetings or on special assignments.
Seniority
Mid-level, hands-on IC