Remote Behavioral Health Quality Advocate (LCSW/LMHC)

Centene Corp.; Tallahassee (FL); Remote; USD 37,000 - 67,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work arrangements (remote/hyb

Flexible work arrangements (remote/hyb

Job summary

Centene is seeking a licensed behavioral health professional to improve access and quality of care for Medicaid members in Florida. This role involves telephonic outreach, education on care gaps, and coordinating with providers to close HEDIS gaps.

The position requires a Master's in Behavioral Health or Social Work (or a nursing degree) and 2–4 years of related experience, with eligibility to hold an active licensure (LCSW, LMSW, LMFT, LMHC, LPC or RN).

Qualifications

• Requires a Master's degree in Behavioral Health or Social Work or a degree from an accredited school of nursing.
• 2-4 years of related experience.

Responsibilities

• Acts as liaison between member/family, physician and facilities/agencies.
• Directly closes FUH, FUM, and FUA HEDIS care gaps with identified members.
• Assist members in connecting to behavioral health providers for ongoing services.
• Schedules doctor appointments for members with behavioral health gaps.
• Conducts telephonic education with members and families about identified care gaps and barriers to care.
• Conducts health coaching and telephonic outreach to support quality improvement and contractual requirements.
• Arranges transportation for members as needed.
• Arranges follow-up appointments for members as needed.
• Documents all actions regarding member contact and interactions with other departments to resolve issues.
• Leads projects and prepares reports to meet department initiatives and quality improvement goals.
• Performs audits and chart reviews to ensure best practices and proper protocol.
• Represents the plan at community and health department meetings focusing on quality improvement.

Education

Master's degree in Behavioral Health or Social Work

Nursing degree from an Accredited School

Job description

Centene is seeking a licensed behavioral health professional to improve access and quality of care for Medicaid members in Florida. This role involves telephonic outreach, education on care gaps, and coordinating with providers to close HEDIS gaps.

The position requires a Master's in Behavioral Health or Social Work (or a nursing degree) and 2–4 years of related experience, with eligibility to hold an active licensure (LCSW, LMSW, LMFT, LMHC, LPC or RN).