California Licensed Care Advocate

Job Summary

California Licensed Care Advocate, responsible for reviewing clinical documentation, making medical necessity determinations, and managing behavioral health cases in a full-time remote position.

Key Responsibilities

• Review clinical documentation to determine medical necessity for behavioral health services
• Process authorization requests and manage behavioral health cases across multiple levels of care
• Document decisions accurately and communicate with providers to gather additional information

Required Qualifications

• Active, independently licensed California clinician credential (LCSW, LMFT, LPCC, Psychologist, or 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, or County-funded healthcare programs
• Strong understanding of medical necessity criteria and authorization processes
• Experience applying clinical criteria for complex behavioral health cases