Behavioral Health Advocate, Utilization Management - Remote

UnitedHealth GroupEden Prairie, MN
1dRemote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. As a Behavioral Health Advocate, you will be responsible for utilization review of behavioral health and substance abuse cases. You'll have a direct impact on the lives of our members as you recommend and manage the appropriate level of care throughout the entire treatment plan. This team receives treatment requests for higher levels of care telephonically and via the STAR chat 2 hours/day. Available schedules are Monday - Friday, 9am - 6pm EST (STAR chat 4pm - 6pm EST), and Monday - Friday, 11am - 8pm EST (STAR chat 6pm - 8pm EST). This position also includes a weekday holiday rotation. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Day to day management and administration of behavioral health benefits for facility-based care Utilize clinical assessments to determining appropriate levels of care Evaluate additional clinical services are needed Effectively coordinate benefits and transitions between various levels of care Identify ways to add value to treatment plans and consult with facility staff to improve outcomes Actively assist in identifying appropriate community-based services for discharge planning for the duration of the course of care You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Requirements

  • One of the following: Independently licensed clinician with a Master's degree in Psychology, Social Work, Counseling, or related behavioral health discipline
  • RN with 2+ years of experience in behavioral health
  • Licenses must be active and unrestricted in the state of residence
  • 2+ years of experience in a related mental health environment
  • Proficient in Microsoft Office Suite including Teams, Word, and Outlook
  • Proven ability to multitask and navigate live chat functions
  • Willingness to work a weekday holiday rotation based on business need
  • Ability to commit to working until 6pm or 8pm EST based upon assigned schedule
  • Dedicated, distraction-free workspace and access to reliable high-speed internet in home (Cable Broadband, DSL, Fiber)

Nice To Haves

  • Utilization review / utilization management experience
  • Experience working in a call center environment
  • Experience working in a queue-based environment
  • Experience in an inpatient setting
  • Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients
  • Experience working with Commercial, Medicare, and Medicaid lines of business
  • Dual diagnosis experience with mental health and substance abuse
  • Proven excellent communication skills both verbally and in writing
  • Proven ability to thrive in a fast-paced environment

Responsibilities

  • Day to day management and administration of behavioral health benefits for facility-based care
  • Utilize clinical assessments to determining appropriate levels of care
  • Evaluate additional clinical services are needed
  • Effectively coordinate benefits and transitions between various levels of care
  • Identify ways to add value to treatment plans and consult with facility staff to improve outcomes
  • Actively assist in identifying appropriate community-based services for discharge planning for the duration of the course of care

Benefits

  • a comprehensive benefits package
  • incentive and recognition programs
  • equity stock purchase
  • 401k contribution
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