Behavioral Health Care Advocate - UM - Remote
About The Position
The Behavioral Health Care Advocate will join Optum’s Behavioral Care team as a Strategic Outpatient Engagement & Management (STEM) Care Advocate. The role conducts telephonic clinical reviews directly with providers to help ensure members receive effective and efficient care and to promote best practices in outpatient psychotherapy and community-based treatment settings. This is an inbound-queue-based, fully remote position. The schedule is Monday through Friday, 10:30 a.m. to 7:00 p.m. Eastern or Central time. The employee may work remotely from anywhere in the United States and must follow UnitedHealth Group’s Telecommuter Policy. The role focuses on outpatient commercial, Medicaid, and Medicare behavioral health services, assessing care against coverage guidelines, partnering with providers on treatment, administering benefits, and reviewing treatment plans.
Requirements
- Active, unrestricted independent-level clinician licensure in Psychology, Social Work, Counseling, or Marriage or Family Counseling.
- Active, unrestricted independent licensure in the state of residence.
- At least 2 years of experience in behavioral health.
- Experience in outpatient psychotherapy and community-based treatment.
- Proficiency with Microsoft Office, including Word, Excel, Outlook, and Internet.
- A distraction-free space at home to use as a home office.
- Access to high-speed DSL or cable internet.
Nice To Haves
- At least 2 years of post-licensure experience in a related mental health environment, including outpatient services.
- Experience working with electronic medical records (EMRs).
- Experience in managed care.
- Experience conducting clinical reviews to determine appropriate levels of care.
- Telephonic or office-based experience.
- Telephone queue experience.
- Utilization review or management experience.
Responsibilities
- Focus on outpatient commercial, Medicaid, and Medicare behavioral health services.
- Conduct outpatient reviews to determine appropriate care.
- Assess whether member care meets coverage guidelines.
- Shape member treatment in partnership with providers to ensure best practices.
- Administer benefits and review treatment plans.
- Conduct telephonic clinical reviews directly with providers.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase plan.
- 401(k) contribution.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
