Care Advocate
$49,920–$49,920 year
Remote · California, United States
Job Summary
Care Advocate (Licensed Behavioral Health Clinician) supports Optum Public Sector San Diego on a remote contract to review clinical documentation, determine medical necessity for behavioral health services, manage cases across inpatient to crisis-intervention levels of care, and coordinate utilization management with providers and internal teams. Responsibilities include authorizing requests, documenting decisions in EHRs, communicating with providers, guiding treatment-plan improvements, coordinating transitions of care to minimize gaps, and ensuring compliance with Medi-Cal and County criteria. The role emphasizes high-volume, detail-oriented remote work within a collaborative team that delivers high-quality behavioral health outcomes.
Required Qualifications
- Active, independently licensed California clinician credential required, including one of: Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), Psychologist, Registered Nurse (RN) with behavioral health experience
- Minimum of 2 years of experience in mental health and/or substance use treatment
- Experience in managed care, utilization management, Medi-Cal, or County-funded healthcare programs
- Strong understanding of medical necessity criteria and authorization processes
- Experience applying clinical criteria and conducting assessments for complex behavioral health cases, including dual-diagnosis populations
- Strong organizational skills and attention to detail
- Ability to work independently in a remote setting while collaborating effectively with internal teams and providers
- Experience with electronic health records and utilization management systems (preferred)
- Positive, collaborative, and proactive approach to work (preferred)
- Strong problem-solving and critical-thinking skills (preferred)
- Excellent written and verbal communication skills (preferred)
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