Behavioral Care Advocate - Outpatient Utilization Review

Lehigh University; Phoenix (AZ); Remote; USD 58,000 - 105,000; Full time

Job summary

A leading health care provider is seeking a Behavioral Care Advocate who will focus on outpatient reviews to ensure effective member care. The role involves assessing treatment plans and collaborating with healthcare providers in a full-time remote capacity, aiming to enhance healthcare systems through compassionate and efficient approaches.

Benefits

Comprehensive benefits package

Incentive and recognition programs

401k contribution

Equity stock purchase option

Qualifications

• 2+ years of experience in behavioral health settings required.
• Preferred licensure in Arizona.
• Distraction-free space at home for office setup.

Responsibilities

• Conduct outpatient reviews for Medicaid and Medicare behavioral health services.
• Ensure member care meets guidelines and participate in treatment shaping.
• Administer benefits and review treatment plans.

Skills

Behavioral health experience

MS Office proficiency

Education

Active, unrestricted licensure in Psychology, Social Work, or Counseling

Tools

Electronic medical records (EMRs)

Job description

The Optum family of businesses, is seeking a Behavioral Care Advocate to join our team. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone.

At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.

The Outpatient Utilization Review Behavioral Care Advocate will complete telephonic clinical reviews directly with Providers to ensure members are getting the most effective and efficient care promoting best practices in the Outpatient psychotherapy and community-based treatment setting.

***This position is inbound-queue based, and is fully remote, with a Monday-Friday, 10:30am - 7:00pm CST schedule***

Primary Responsibilities:

• Focus on outpatient commercial, Medicaid and Medicare behavioral health services
• Conducting outpatient reviews to determine appropriate care
• Assessing if member care meets coverage guidelines
• Shaping member treatment in partnership with providers to ensure best practices
• Administering benefits and reviewing treatment plans

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.

Required Qualifications:

• Active, unrestricted, Independent Level Clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling, or an RN with 2+ years of experience in behavioral health
• Active, unrestricted licensure
• 2+ years of experience in a behavioral health setting
• Outpatient psychotherapy and community-based treatment experience
• Proven MS Office proficiency (Word, Excel, Outlook, Internet)
• Distraction-free space in home to use as a home office
• Access to high-speed internet (DSL or Cable)

Preferred Qualifications:

• Licensure in the state of Arizona
• 2+ years of demonstrated experience (post licensure) in a related mental health environment including outpatient services
• Experience working with EMRs (electronic medical records)
• Experience in managed care
• Experience conducting clinical review to determine appropriate levels of care
• Demonstrated telephonic/office-based experience
• Telephone queue experience
• Utilization review/management experience

Explore opportunities at Optum Behavioral Care. We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while Caring. Connecting. Growing together.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.