Behavioral Health Care Advocate - Remote

Role Overview

The Care Advocate undertakes remote clinical telephonic reviews with healthcare providers to ensure members are receiving appropriate outpatient behavioral health services such as psychotherapy and community-based interventions. Responsibilities include evaluating treatment appropriateness, collaborating with providers to develop effective care plans, and managing benefits aligned with coverage policies.

Key Responsibilities

• Perform outpatient clinical reviews for behavioral health services across commercial, Medicaid, and Medicare populations.
• Assess whether member care complies with the stipulated coverage standards.
• Work closely with treatment providers to encourage adherence to best practices.
• Manage benefit approvals and review treatment plans accordingly.

Qualifications and Skills

• Possess an active, unrestricted independent license in Psychology, Social Work, Counseling, or Marriage & Family Counseling.
• Minimum of 2 years’ experience in behavioral health, with exposure to outpatient and community-based treatments.
• Proficient in Microsoft Office and telehealth platforms.
• Excellent verbal communication skills suitable for phone-based interactions.
• Access to dependable high-speed internet and a quiet, distraction-free home workspace.

Preferred Experience

• Experience in post-licensure outpatient mental health settings.
• Familiarity with Electronic Medical Records (EMRs) and managed care systems.
• Competency in utilization review and clinical assessments.
• Ability to manage phone review queues efficiently.

Additional Information

The position is fully remote, supporting a work environment that values innovation, diversity, and opportunities for professional development while positively impacting community health.