Behavioral Health Care Advocate (Utilization Review, Outpatient) - Remote

Optum; Maryland Heights (MO); Remote; USD 58,000 - 105,000; Full time

Job summary

A leading healthcare organization is seeking a Behavioral Health Care Advocate to join their remote team. Your role will involve conducting clinical reviews to ensure effective care is provided. The ideal candidate will have a background in psychology or social work, with 2+ years in a behavioral health setting. This position promotes a transformative approach to healthcare, connecting care seamlessly across various settings.

Benefits

Comprehensive benefits package

401k contribution

Equity stock purchase

Qualifications

• Active, unrestricted licensure in Psychology, Social Work, Counseling, or Marriage or Family Counseling.
• 2+ years of experience in a behavioral health setting.
• Experience in outpatient psychotherapy and community-based treatment.

Responsibilities

• Focus on outpatient commercial, Medicaid and Medicare behavioral health services.
• Conduct outpatient reviews to determine appropriate care.
• Shape member treatment in partnership with providers.

Skills

Psychology

Social Work

Counseling

Microsoft Office proficiency

Education

Active, unrestricted licensure in state of residence

Independent Level Clinician

Job description

Overview

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

At OptumHealth, you will work within an innovative culture focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business and contribute in ways that have a meaningful impact.

The Strategic Outpatient Engagement & Management (STEM) Care Advocate will complete telephonic clinical reviews directly with providers to ensure members receive the most effective and efficient care, promoting best practices in outpatient psychotherapy and community-based treatment settings.

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

You will have the flexibility to work remotely from anywhere within the U.S. as you take on challenging opportunities.

Primary 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

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 in your state of residence
• 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 Kansas or Kentucky
• 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.

*All employees working remotely will be required to adhere to UnitedHealth Group\'s Telecommuter Policy.

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 come down early due to volume of applicants.

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. There are still barriers to good health experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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