The overall purpose of the Behavioral Health Care Advocate is to coordinate care with members in order improve the member's ability to remain stable in the community and out of the hospital. This coordination includes intensive coordination, discharge coordination, and care coordination for members. The Behavioral Health Care Advocate role is to engage the person in the treatment process and then assist his/her to access the appropriate community services so they can pursue their treatment goals in the community and avoid institutionalization. This position focuses on members with high needs, high utilization, and in need of complex Behavioral Health Care Coordination and works closely with members, providers, State stakeholders, Utilization Management, and Peer Support.

The Behavioral Health Care Advocate position is also designed to be a direct clinical liaison between providers and the health plan and works in conjunction with the Quality and Network team to assist providers with technical support, including education in clinical managed care and education in clinical best practices.

If you are located in Memphis, TN, you will have the flexibility to telecommute as you take on some tough challenges.




Primary Responsibilities:

• Performing care management activities to ensure that patients move through the continuum of care efficiently and safely
• Assessing and interpreting customer needs and requirements
• Reviews cases and analyzes clinical information in conjunction with Medical Directors to determine the appropriateness of hospitalization
• Performing Clinician to Physician interaction to acquire additional clinical information or discuss alternatives to current treatment plans
• Escalates cases to the Medical Director for case discussion or peer-to-peer intervention as appropriate
• Performs anticipatory discharge planning in accordance with the patient's benefits and available alternative resources
• Collaborates with Medical peers on consideration of discharge planning needs
• Refers patients to disease management or case management programs
• Assists with the development of treatment plans
• Documents activities according to established standards