Large managed care company is looking for a Care Advocate with excellent customer service skills and the ability to think and act quickly in fast-paced settings for a long-term contract.
Work Location: FULLY REMOTE - Must have current, unrestricted license to practice in the state of Maryland
Pay: $40.00
Contract Dates: 4/22/24 - 12/31/24
RESPONSIBILITIES
- Perform telephonic reviews, obtain relevant clinical information from behavioral health providers, determine appropriate levels of care, and administer public behavioral health benefits.
- Perform brief crisis assessment and triage for participants and/ or family members calling into the crisis call queue.
- Perform initial and continued stay requests for authorization on assigned level of care. Which may include Behavioral Health (BH), PRP, or substance use disorder (SUD) services submitted through a provider portal.
- Obtain additional information from providers on BH, PRP or (SUD) requests for treatment as needed.
- Cover crisis line/precent for acute levels of care on holidays.
- Coordinate transitions between various levels of care.
QUALIFICATIONS
- Licensed master’s degree level clinician in: Psychology, Social Work, Counseling or Marriage or Family Counseling; OR Licensed psychologist; OR Registered Nurse with Behavioral Health experience.
- Current, unrestricted license to practice in the state of Maryland.
- 2+ years of experience in behavioral health.
- Access to high-speed internet (Cable Broadband, DSL, Fiber Optic) and a dedicated, distraction-free workspace at home
PREFERED QUALIFICATIONS
- Dual diagnosis experience with mental health and substance use disorders
- Experience with Medicaid populations
- Experience with utilization management
- Experience working in an environment that required coordinating benefits and utilizing multiple groups and resources for participants.
- Telephonic queue/ Call Center experience
- Knowledge of Maryland Medicaid Level of Care Guidelines
- Proficient in utilizing medical necessity criteria and ASAM in determining appropriate level of care.
- Proficiency with Microsoft Office Suite programs (Word, Outlook, Internet)
- Bilingual Spanish