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Quality Behavioral Health Advocate
Centene Corporation. Work with members and providers to close behavioral health care gaps and remove barriers to care .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in behavioral health care, focusing on closing care gaps and improving HEDIS measures through effective outreach and collaboration. Holds relevant licensure and a master's degree, with a strong emphasis on quality improvement and member advocacy.
Highest-signal resume keywords
LCSW LicensureBehavioral Health ExperienceHEDIS Measures KnowledgeTelephonic Outreach SkillsQuality Improvement Initiatives
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Behavioral Health CoachingChart ReviewsAuditsData ExtractsQuality Improvement InterventionsMember AdvocacyCare Gap IdentificationAppointment SchedulingCommunity Resource ConnectionHealth Education
Soft Skills
CollaborationCommunicationProblem-SolvingTrainingConfidentiality Maintenance
Certifications & Qualifications
Active LCSWLMFTLMHCLPC Licensure
Industry Keywords
MedicaidBehavioral Health CareHEDISQuality ImprovementTelephonic OutreachMember ExperienceHealthcare ComplianceCommunity-Based ResourcesHealth CoachingEmergency Room Discharge
About the role
Key responsibilities & impact- Work with members and providers to close behavioral health care gaps and remove barriers to care
- Improve member and provider experience through targeted outreach
- Collaborate with members and providers to improve behavioral health HEDIS measures
- Support behavioral health quality improvement interventions
- Conduct telephonic outreach to Medicaid members recently discharged from the Emergency Room/ED
- Provide education and health coaching to members and families regarding identified care gaps
- Schedule doctor and follow-up appointments
- Arrange transportation and connect members with community-based resources and affinity programs
- Act as a liaison and member advocate between members/families, physicians, facilities, and agencies
- Document all member contacts and actions taken
- Interact with other departments, including customer service, to resolve member issues
- Refer members to case or disease management as appropriate
- Provide coaching and training to Quality Behavioral Health Advocates
- Act as subject matter expert on departmental best practices, reports, and data extracts
- Lead preparation and submission of projects, reports, and assignments
- Assist with new and expanding healthcare QI/HEDIS initiatives
- Represent the supervisor in meetings and special assignments
- Help establish process improvements and implement departmental changes
- Conduct audits and chart reviews of fellow Quality Behavioral Health Advocates
- Participate in community, health department, collaborative, and organizational quality improvement meetings
- Comply with all policies and standards
- Perform other duties as assigned
Requirements
What you’ll need- Applicants must reside in the state of Florida
- Active, current, unrestricted LCSW, LMFT, LMHC or LPC licensure required
- Master's degree in Behavioral Health or Social Work, or a degree from an accredited school of nursing
- 2–4 years of related experience
- Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements, with behavioral health experience required
- Knowledge of behavioral health care gaps, HEDIS measures, quality improvement, and regulatory/contractual requirements
- Ability to conduct telephonic outreach, education, health coaching, audits, and chart reviews
- Ability to maintain confidentiality of business and protected health information
Benefits
Comp & perks- Competitive pay
- Health insurance
- 401K
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation
- Equal opportunity employer committed to diversity