Behavioral Health Care Advocate Resume Samples

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EM
E Monahan
Emmy
Monahan
2119 Nina Creek
Houston
TX
+1 (555) 776 0610
2119 Nina Creek
Houston
TX
Phone
p +1 (555) 776 0610
Experience Experience
Houston, TX
Behavioral Health Care Advocate
Houston, TX
Nikolaus-Daniel
Houston, TX
Behavioral Health Care Advocate
  • Obtaining information from providers on outpatient requests for treatment
  • Identifying ways to add value to treatment plans and consulting with facility staff or outpatient care providers on those ideas
  • Track patient follow up and clinical outcomes using an electronic system. Document in-person and telephone encounters using the system to identify and re-engage patients. Such registry functions can be accomplished through an existing software system, EHR build, on a spreadsheet used in conjunction with an EHR, or can be built into a stand-alone clinical management tracking system that may or may not be linked to an EHR
  • The Behavioral Health Advocate will develop relationships with community based behavioral health service providers in order to develop procedures and communications that will foster coordination and collaboration of care for our members in the following ways
  • Collaboration with Community Based Behavioral Health Providers
  • Develops processes to coordinate behavioral health care between the member's primary care provider (PCP) and behavioral health service provider
  • Referring members to behavioral health providers based upon health assessments or as identified by inpatient and outpatient case management staff
Chicago, IL
Field Behavioral Health Care Advocate
Chicago, IL
Abernathy and Sons
Chicago, IL
Field Behavioral Health Care Advocate
  • Manages the aftercare follow - up of identified high risk enrollees (manages follow - up calls / outreach and documentation)
  • Assists enrollees with appointments
  • May go to facilities to develop successful plan of care
  • Liaison with other case managers and UM staff to help coordinate services and treatment
  • Identify any gaps or barriers that would impact compliance with the prescribed treatment plan
  • May travel throughout assigned region up to 50% of the time
  • May attend rounds with the clinical team
present
Boston, MA
Utilization Review Behavioral Health Care Advocate
Boston, MA
Heidenreich-Franecki
present
Boston, MA
Utilization Review Behavioral Health Care Advocate
present
  • Identify ways to add value to treatment plans and consulting with facility staff or outpatient care providers on those ideas
  • Manage inpatient and outpatient mental health cases throughout the entire treatment plan
  • Obtain information from providers on outpatient requests for treatment
  • Administer benefits and review treatment plans
  • Coordinate benefits and transitions between various areas of care
  • Focus on initial inpatient admission for psychiatric and chemical dependency patients
  • Participate in regularly scheduled (usually weekly) caseload consultation with the psychiatric consultant and communicate resulting treatment recommendations to the patient’s medical provider. Consultations will focus on patients new to the caseload and those who are not improving as expected under the current treatment plan. Case reviews may be conducted by telephone, video, or in person and may include members of Monarch’s clinical care team
Education Education
Master’s Degree in Psychology
Master’s Degree in Psychology
The University of Kansas
Master’s Degree in Psychology
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15 Behavioral Health Care Advocate resume templates

1

Behavioral Health Care Advocate Resume Examples & Samples

  • 2 years post - Masters experience in a related mental health environment
  • Prior Call Center experience
  • Facility based experience
2

Behavioral Health Care Advocate Resume Examples & Samples

  • Licensed Chemical Dependency Professional (CDP) in State of Washington
  • License must be active and unrestricted in State of Washington
  • 2+ years experience behavioral health / mental health environment
  • Ability to use various computer applications and move through computer screens while talking with members on telephone
3

Behavioral Health Care Advocate Resume Examples & Samples

  • Provide telephonic case management in a fast-paced, technology enabled, call center environment
  • Apply dynamic clinical expertise to support a wide range of behavioral health conditions
  • Use critical thinking skills to prioritize high impact behavior changes that maximize consumer’s ability to address gaps in treatment and successfully leverage the health care system
  • Care to act and be a transformational force in health care
  • Management and authorization of behavioral health services, including crisis assessment and intervention
  • Integrates a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates the options and services to meet the enrollee’s health needs, using education, communication, and all available resources to promote quality, cost-effective outcomes
  • Discharge planning or management of transitions between care settings to ensure the appropriate services/resources are in place for quality outcomes
  • Management of medical and behavioral care coordination for all complexity levels
  • Coordinates and authorizes medically appropriate services for members to facilitate cost-effective member outcomes in a timely manner
  • Make outreach calls to members and/or providers for coordination of behavioral and medical services
  • Assist consumers by screening, answering questions, providing program information and education about care coordination program services, network and community resources, and coverage determinations in an accurate and courteous manner
  • Attend / participate in all required Medica facilitated meetings and / or trainings and if a Care Coordinator does not attend, they are responsible to review all materials presented
  • Professional development: Motivational Interviewing coaching skills, advanced certification, ongoing CEUs
  • Act with autonomy as an independent practitioner
  • Career advancement across the enterprise
  • Independently licensed in the state of Minnesota as a LP, LPC, LICSW, LPCC, LMFT or as an RN with 2 or more years of experience in behavioral health
  • 2+ years post - Masters clinical experience in a related mental health environment
  • Experience working in a strength base recovery model
  • Experience with motivational interviewing
  • Case Management experience managing a large case load
  • Familiar with utilization review
  • Experience working in programs or higher levels of care
  • Knowledge of common medical conditions and services such as diabetes, asthma, etc
4

Behavioral Health Care Advocate Resume Examples & Samples

  • Provide crisis intervention for county consumers. Conduct psychiatric and drug / alcohol clinical screenings, referrals for psychiatric treatment, referrals for alcohol / drug services, and provide authorization for inpatient and outpatient treatment requests for Medi - Cal insured consumers
  • Facilitate enrollment of consumers to programs or provider agencies; provide information referrals; perform provider profiling activities
  • Use computerized database to support management of care and benefits
  • Assist with problem resolution as needed
  • Participate in CQI activities; as directed by supervisor
  • Requires access to the following electronic applications which include Protected Health Information
  • Adheres to pertinent HIPAA rules and regulations
  • 5+ years' direct clinical experience in mental health and / or alcohol / drug intervention and treatment setting with emphasis on crisis intervention
  • Community mental health and / or Public Sector and Medi - Cal or Medicaid experience required
  • Ability to use a PC in a Windows environment, including MS Word
  • Inpatient experience preferred
  • Managed Care experience preferred
  • Bilingual (Spanish, Vietnamese, Arabic, or Tagalog) strongly preferred
  • Experience working in a Call Center setting
  • Applied Suicide Intervention Skills Training
  • Trauma Informed Care experience
5

On-site Behavioral Health Care Advocate Resume Examples & Samples

  • Conduct screenings on Offenders for referral to the appropriate level of care
  • Collaborate with Probation Officers on case consultation / planning and referrals for treatment as indicated
  • Schedule follow - up appointments for program participants with local clinics throughout San Diego County
  • Case management as needed
  • Counsel and encourage program participants to seek assistance with substance abuse, chemical dependency and other behavioral issues
  • Create and maintain thorough documentation of all cases
  • Registered psychiatric nurse or licensed master’s level mental health professional. LMFT, LCSW, LPC, Psych RN, PsyD, PhD
  • 3+ years' providing direct clinical care in a behavioral health treatment setting with emphasis on assessment, case management, and crisis intervention
  • Community behavioral health experience
  • In-patient and/or out-patient experience
  • Experience in working with any or all of the following: mental health, severe mental health, drug and alcohol abuse, etc
  • Knowledge of the system of care in San Diego
  • Working with patients who are in or have been in the Criminal Justice system
6

Behavioral Health Care Advocate Possible Telecommute Resume Examples & Samples

  • Complete assessments to determine appropriate levels of care
  • Crisis management, substance abuse and mental health background
  • Ability to talk on phone and navigate through computer screens simultaneously
  • Facility - based experience (inpatient, residential, partial, iop)
  • A background working with various age groups
  • Prior call center experience
7

Behavioral Health Care Advocate Resume Examples & Samples

  • Coordinate transitions between various areas of care
  • Coordination of care for members with behavioral health needs
  • Collaborate with provider and facilities as applicable
  • Coordinate and collaborate needs with other individuals within local team including roles such as Community Health Workers, RN’s and Social Workers
  • Licensed Master's degree in Psychology, Social Work, Counseling or Marriage Family Counseling, or Licensed Ph.D., or an RN with 2 or more years of experience in behavioral health. Licenses must be independent, active, and unrestricted
  • 2+ years of behavioral health experience
  • Reside in the greater Maricopa County, AZ area
  • Ability to travel in the field in the greater Maricopa County area as needed
  • CCM
8

Behavioral Health Care Advocate Resume Examples & Samples

  • Focus on outpatient services for psychiatric and chemical dependency patients
  • Managing outpatient mental health cases to shape and encourage best practices
  • Coordinating benefits and transitions between various areas of care
  • Identifying ways to add value to treatment plans and consulting with facility staff or outpatient care providers on those ideas
  • Active, unrestricted Licensed Master's degree - level clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling OR Licensed Ph.D., OR an RN with 10+ years of experience in behavioral health
  • 2+ years of demonstrated experience in a related mental health environment including outpatient services
  • MS Office proficiency (Word, Excel, Outlook, Internet)
  • Demonstrated telephonic / office - based experience
  • Must have the ability to talk on the phone and type at the same time
  • Outpatient experience
  • Community based service experience
  • Basic understanding of claims and billing
  • Understanding of good treatment planning
9

Behavioral Health Care Advocate Resume Examples & Samples

  • Master's Degree
  • Licensed Mastered Health Professional (LMHP)
  • CDP experience is a plus
10

Behavioral Health Care Advocate Resume Examples & Samples

  • Screen and assess patients for common mental health and substance abuse disorders. Facilitate patient engagement and follow-up care
  • Provide patient education about common mental health and substance abuse disorders and the available treatment options
  • Systematically track treatment response and monitor patients (in person or by telephone) for changes in clinical symptoms and treatment side effects or complications
  • Support psychotropic medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment
  • Provide brief behavioral interventions using evidence-based techniques such as behavioral activation, problem-solving treatment, motivational interviewing, or other treatments as appropriate
  • Provide or facilitate in-clinic or outside referrals to evidence-based psychosocial treatments (e.g. problem-solving treatment or behavioral activation) as clinically indicated
  • Participate in regularly scheduled (usually weekly) caseload consultation with the psychiatric consultant and communicate resulting treatment recommendations to the patient’s medical provider. Consultations will focus on patients new to the caseload and those who are not improving as expected under the current treatment plan. Case reviews may be conducted by telephone, video, or in person and may include members of Monarch’s clinical care team
  • Track patient follow up and clinical outcomes using an electronic system. Document in-person and telephone encounters using the system to identify and re-engage patients. Such registry functions can be accomplished through an existing software system, EHR build, on a spreadsheet used in conjunction with an EHR, or can be built into a stand-alone clinical management tracking system that may or may not be linked to an EHR
  • Document patient progress and treatment recommendations in an electronic system and other required systems so as to be shared with medical providers, psychiatric consultant, the Monarch clinical team and other treating providers
  • Facilitate treatment plan changes for patients who are not improving as expected in consultation with the medical provider and the psychiatric consultant and who may need more intensive or more specialized mental health care
  • Facilitate referrals for clinically indicated services under the behavioral health benefit (e.g., social services such as housing assistance, vocational rehabilitation, mental health specialty care, substance abuse treatment)
  • Develop and complete relapse prevention self-management plan with patients who have achieved their treatment goals and are soon to be discharged from the caseload
  • Works collaboratively with members of the Monarch clinical team which may include a nurse case manager, pharmacist, social worker, disease management team and palliative care team to coordinate behavioral and medical needs
  • Facilitate referrals for clinically indicated services under the patient’s medical benefit
  • 3+ years of Behavioral Health experience
  • Proficient computer skills
  • Ability to adapt to a quickly changing work environment
  • Must reside in the greater Orange County area
  • CCM - Certified Case Manager
  • Addiction medicine expertise
  • Ability to maintain effective and professional relationships with patient and other members of the care team
  • Experience with screening for common mental health and/or substance abuse disorders
  • Working knowledge of differential diagnosis of common mental health and/or substance abuse disorders
  • Ability to effectively engage patients in a therapeutic relationship
  • Ability to work with patients by telephone as well as in person
  • Experience with assessment and treatment planning for common mental health and/or substance use disorders
  • Working knowledge of evidence-based psychosocial treatments and brief behavioral interventions for common mental health disorders, when appropriate (e.g., motivational interviewing, problem-solving treatment, behavioral activation)
  • Basic knowledge of psychopharmacology for common mental health disorders that is within appropriate scope of practice for type of provider filling role
  • Experience with evidence-based counseling techniques
11

Telephonic Behavioral Health Care Advocate Resume Examples & Samples

  • Determining if additional clinical services are needed
  • Coordinating benefits and transitions between various levels of care
  • Identify appropriate community based services for discharge planning as indicated
  • Licensed Master's degree in Psychology, Social Work, Counseling or an RN with 2+ years of experience in behavioral health
  • Proficiency with Microsoft Office Suite programs (Word, Outlook, Internet)
  • Must live within a commutable distance (maximum of one hour) of one of the listed office locations
  • Experience working with the geriatric patient population
  • Experience with Medicaid
  • Previous experience in a managed care environment
12

Behavioral Health Care Advocate Resume Examples & Samples

  • Licenses must be active and unrestricted in your state of residence
  • 2+ years experience in mental/behavioral health
  • Computer / typing proficiency to enter / retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications
  • Access to reliable transportation and the ability to accommodate some field-based travel within the service delivery area
  • Access to high speed internet from home
  • Experience with the Medicaid population
13

Behavioral Health Care Advocate Resume Examples & Samples

  • Managing inpatient and outpatient mental health cases throughout the entire treatment plan
  • Independently Licensed Master's degree - level clinician in Psychology, Social Work, Counseling
  • Active and unrestricted license: LCSW, LPC, PhD or RN with behavioral health experience
  • Managed Care experience
14

Behavioral Health Care Advocate Resume Examples & Samples

  • *This position requires some field - based travel within the Maricopa County, AZ region***
  • Participates as part of an interdisciplinary clinical team serving the member
  • Coordinates member behavioral health care needs with community based behavioral health service providers both telephonically and in - person when clinically indicated
  • Develops processes to coordinate behavioral health care between the member’s primary care provider (PCP) and behavioral health service provider
  • Participates in the identification of best practices for behavioral health in a primary care setting
  • Coordinates behavioral health care with medically necessary services
  • Conducts trainings with the clinical team on behavioral health issues
  • Attends provider team meetings and other provider activities as needed
  • Meets with the member in the community as appropriate by need and market
  • Licensed Master's Degree level clinician in: Psychology, Social Work, Counseling or Marriage & Family Counseling; or Licensed Ph.D. or Licensed PsyD; or an RN with 2 or more years of experience in behavioral health
  • Licensures must be active and unrestricted in the state of Arizona
  • 2 years of behavioral health experience
  • Reliable transportation and the ability to accommodate some field - based travel as needed within the service delivery area
  • Function independently and responsibly with minimal supervision
  • Ability to maintain direct and open communication with all levels of the organization
  • Experience working with low - income populations (Medicaid)
  • Knowledge of Level of Care Guidelines (i.e. Milliman)
15

Behavioral Health Care Advocate Resume Examples & Samples

  • Crisis line coverage in rotation with other team members, taking calls from members, providers and others, reviewing clinical data for medical necessity, and authorizing services as appropriate
  • Case load management, to include: reviewing initial and concurrent requests for services, assessing requests and clinical data against medical necessity criteria in guidelines, issuing authorizations, consulting with physicians on denials, and following member cases through to completion, ensuring members receive the care they need, when they need it, in the most appropriate and least restrictive setting
  • Review of members’ medical records from providers to determine if mental health and substance abuse services delivered are medically necessary, if they are coordinated with other services and providers, if providers have individualized treatment plans for members, etc
  • Speaking with members to complete clinical assessments, impact member engagement, assist in care coordination, etc
  • Work as part of a multidisciplinary team in a company dedicated to Integrated Healthcare in TN
  • Must be an independently licensed Masters - level mental health professional, licensed Ph.D. or registered nurse
  • 2+ years of clinical experience in a related mental / behavioral health setting
  • Proficiency with Microsoft Office Suite, ability to learn and navigate multiple proprietary software applications; typing proficiency
  • Must live within a commutable distance of our Brentwood or Knoxville office locations
  • Experience with Medicare / Medicaid members and providers (specific TennCare experience)
  • Familiarity with recovery and resiliency model
  • Crisis line or experience with triaging behavioral health crisis calls / situations
  • Experience with the current Diagnostic and Statistical Manual and best practice standards for treatment
  • Bilingual skills
  • Ability to work in a fast - paced, ever - changing office environment and handle change well
  • Ability to work as a member of an integrated healthcare team, internally and externally
  • Ability to multitask between different systems and cases
  • Ability to maintain comprehensive electronic records
  • Strong Interpersonal and critical thinking skills; ability to negotiate and make quick, efficient and effective decisions to resolve cases and issues
16

Behavioral Health Care Advocate Resume Examples & Samples

  • Master's Level Licensed Degree in Psychology, Social Work, Counseling or Marriage or Family Counseling or Licensed Ph.D, or an RN with 2 or more years of experience in behavioral health
  • 2+ years experience in a behavioral/mental health setting
  • Must reside in the state of Wisconsin
  • Dedicated work space from home
  • Must have reliable transportation and the ability to travel within the service delivery area as needed
  • Experience working with the Medicaid population
  • Residence in the Green Bay, WI area highly desired
17

Behavioral Health Care Advocate Resume Examples & Samples

  • 2+ years experience in a related behavioral / mental health setting
  • Basic Microsoft Office skills
  • Onsite training in our Latham, NY office may be required for candidates that are within a commutable distance
  • Experience in a Managed Care Organization highly preferred
  • Experience with the NY Medicaid patient population and levels of care
  • Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for members
  • Experience with older adults with a mental health condition or SUD
  • Experience with high risk groups such as individuals with SMI, co - occurring major mental disorders and SUDs and those involved in multiple services systems (education, justice, medical, welfare, and child welfare)
  • Experience with Individuals with a mental health condition or a SUD and co - occurring chronic physical health conditions
  • Experience with individuals with a SUD in need of medication - assisted treatment, including methadone and buprenorphine for opioid dependence
18

Behavioral Health Care Advocate Resume Examples & Samples

  • Obtain information from providers as needed for treatment planning
  • Licenses must be active and unrestricted in PA, NJ, or DE
  • Must live within a commutable distance of our Philadelphia, PA office location
  • Experience in an inpatient or other facility-based care setting
19

Behavioral Health Care Advocate Resume Examples & Samples

  • Proficient Microsoft skills (Word, Excel, Outlook) with the ability to toggle between multiple systems
  • Must live within a commutable distance of our Baton Rouge, LA office location
  • Previous facility-based experience
20

Behavioral Health Care Advocate Resume Examples & Samples

  • Focus on whole person care model for psychiatric and chemical dependency patients
  • Manage behavioral health cases throughout the entire treatment plan
  • 2+ years post-Masters experience in a related mental health environment
  • Clinical Licensure must be independent, current, and unrestricted for the State of Rhode Island
  • Access to high speed internet for home office set up and a dedicated work space at home
  • Ability to adapt well to an ever-changing and dynamic work environment
  • Experience working with a variety of populations within the community
  • Field based experience
21

Senior Field Behavioral Health Care Advocate Resume Examples & Samples

  • Visit Medicaid members in their homes and/or other settings, including community centers, hospitals or providers’ offices
  • Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction
  • Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels
  • Assist members with the transition from a care facility back to their home
  • Master's degree behavioral health OR
  • Medical/Behavioral setting experience (i.e. hospital, managed care organization, or joint medical/behavioral outpatient practice)
  • Clinical training experience
22

Behavioral Health Care Advocate Resume Examples & Samples

  • Licenses must be active and unrestricted in the state of Kansas
  • 2+ years experience in a related mental health setting
  • Experience with the Medicaid/Medicare population
  • Bilingual skills (fluency in Spanish/English)
23

Behavioral Health Care Advocate Telecommute Possibility Resume Examples & Samples

  • Focusing on initial concurrent reviews for higher levels of care, ie: Inpatient, Residential and Partial hospital admissions. Inpatient admission for psychiatric and chemical dependency patients via telephone
  • Obtaining information from providers on outpatient requests for treatment. Facility Based Care Advocates only work with providers for outpatient request prior to discharge from inpatient, residential and partial levels of care
  • Managing inpatient and outpatient (Intermediate levels of care, ie: Residential and Partial) mental health/substance abuse cases throughout the entire treatment plan
  • Overseeing the facility based care experience
  • Licensed Master's degree in Psychology, Social Work, Counseling or Marriage or Family Counseling, or Licensed Ph.D., or an RN with 2 or more years of experience in behavioral health
  • Inpatient experience
24

Behavioral Health Care Advocate Resume Examples & Samples

  • License must be active and unrestricted
  • 2+ years of experience in a related behavioral/mental health environment
  • Working knowledge of Behavioral Health resources in the state of Nebraska
  • Must reside in the state of Nebraska
  • Dual diagnosis experience with behavioral/mental health and substance abuse
  • Dual SNP experience
25

Utilization Review Behavioral Health Care Advocate Resume Examples & Samples

  • Obtain information from providers on outpatient requests for treatment
  • Identify ways to add value to treatment plans and consulting with facility staff or outpatient care providers on those ideas
  • Licensed Master's degree in Psychology, Social Work, Counseling or Marriage or Family Counseling, or Licensed Ph.D., or an RN with 2 or more years of experience with a behavioral/mental health focus
  • 3+ years of hands-on clinical experience in a related mental health environment
  • Proficient Microsoft skills (Word, Excel, Outlook)
  • Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients
26

Field Behavioral Health Care Advocate Resume Examples & Samples

  • This is a field-based role that will require travel throughout the Tidewater region. You will be spending approximately 75% of the time in the field within an assigned coverage area. Candidates must be willing to travel to the following counties: Westmoreland, Essex, Richmond, King William, King and Queen, Lancaster, Accomack, Northampton, Northumberland, Middlesex, Gloucester, Mathews, James City, Surry, Sussex, Southampton, Suffolk, Chesapeake, Virginia Beach, Norfolk, Portsmouth, York, Williamsburg, Newport News, Emporia and Hampton**
  • Conducts initial and follow - up assessments within designated timeframes on enrollees identified as having complex case management needs (assessment areas include clinical, behavioral, social, environmental and financial)
  • Identify any gaps or barriers that would impact compliance with the prescribed treatment plan
  • May travel throughout assigned region up to 50% of the time
  • May go to facilities to develop successful plan of care
  • May attend rounds with the clinical team
  • Master's degree in Psychology, Social Work, Counseling or Marriage or Family Counseling, or an RN with 2+ more years of experience in psychiatric nursing
  • Independent, active and unrestricted Mental Health License to include PsyD, LP, LPCC, LISW, IMFT or RN in the state of VA
  • 1+ year Community Mental Health experience
  • Dedicated space for home office set up and access to high speed internet services
  • Medical / Behavioral setting experience (i.e. hospital, managed care organization, or joint medical / behavioral outpatient practice)
  • Experience working with either Medicaid or Medicare funded programs
27

Field Behavioral Health Care Advocate Resume Examples & Samples

  • This is a field - based role that will require travel throughout the Northern VA region. You will be spending approximately 75% of the time in the field within an assigned coverage area. Candidates must be willing to travel to the following counties: Arlington, Fairfax, Prince William, Strafford, Spotsylvania, Orange, Culpeper, Madison, Greene, Rappahannock, Page, Warren, Fauquier, Loudoun, Clarke, Frederick, Shenandoah and King George**
  • Conducts initial and follow-up assessments within designated timeframes on enrollees identified as having complex case management needs (assessment areas include clinical, behavioral, social, environmental and financial)
  • Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated
  • Medical / Behavioral setting experience (i.e. hospital, managed care organization, or joint medical/behavioral outpatient practice)
28

Behavioral Health Care Advocate Resume Examples & Samples

  • Provide behavioral health care case management for Wyoming Medicaid clients as part of larger multi-disciplinary team service delivery model
  • Coordinates member behavioral health care needs with community based behavioral health service providers both telephonically and in-person when clinically indicated
  • Develops processes to coordinate behavioral health care between the member's primary care provider (PCP) and behavioral health service provider
  • Attends internal/external rounds and meetings as needed
  • Collaboration with Community Based Behavioral Health Providers
  • The Behavioral Health Advocate will develop relationships with community based behavioral health service providers in order to develop procedures and communications that will foster coordination and collaboration of care for our members in the following ways
  • Assisting the clinical team in monitoring and evaluating ongoing services for appropriateness, cost effectiveness, compliance and outcomes
  • Defining care coordination roles and collaboration following inpatient treatment
  • Supporting communication and coordination of the treatment plan between the PCP and behavioral health provider
  • Supporting the PCP in making appropriate referrals for behavioral health services
  • Referring members to behavioral health providers based upon health assessments or as identified by inpatient and outpatient case management staff
  • Addressing concerns regarding access to care appointments and any barriers to care encountered by our members
  • Defining the roles of engagement for common physical/psychological illnesses
  • Licensed Master's degree in Psychology, Social Work, Counseling or Marriage or Family Counseling, or Licensed Ph.D., OR an RN with 2 or more years of experience in behavioral health
  • Clinical Licensure must be current and unrestricted for the State of Wyoming
  • Access to high speed internet services
  • Experience working with the children, families, aged, blind or disabled
  • 2-5 years of managed care and utilization management experience
29

Utilization Review Behavioral Health Care Advocate Telecommute East Coast Resume Examples & Samples

  • Concurrent care management, effectively influencing facility treatment toward best practices and ongoing stabilization and well - being for our members
  • Assessing inpatient, residential, and partial hospital treatment needs based on Level of Care Guidelines
  • Licensed Master's degree in Psychology, Social Work, Counseling or Marriage or Family Counseling, or Licensed Ph.D
  • Experience in a managed care setting