Behavioral Health Escalation Advocate - Remote

Optum; Maryland Heights (MO); Remote; USD 58,000 - 115,000; Full time

Job summary

An established industry player is seeking an Escalations Advocate to join their dynamic team. This role offers a unique opportunity to make a significant impact on health outcomes by connecting individuals with essential care and resources. The ideal candidate will possess strong analytical skills and a detail-oriented mindset, working collaboratively across multidisciplinary teams. With a focus on continuous learning and professional development, this position promises a rewarding experience in a supportive environment, where your contributions will be valued and recognized. Join a mission-driven organization dedicated to improving health equity and making a difference in communities across the globe.

Benefits

Comprehensive Benefits Package

Incentive and Recognition Programs

401k Contribution

Equity Stock Purchase

Qualifications

• 5+ years of behavioral health care experience.
• 3+ years of customer service experience in healthcare.

Responsibilities

• Manage a challenging role in a fast-paced environment.
• Achieve timely resolution to urgent and non-urgent issues.
• Analyze issues and conduct root cause analysis.

Skills

Analytical Skills

Critical Thinking

Communication Skills

Customer Service

Behavioral Health Knowledge

Education

Behavioral Health Clinical Licensure

Tools

Linx

ICUE

OCM

Windows PC Applications

Job description

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, support, guidance, and the resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Escalations Advocate is an individual contributor role responsible for an exciting variety of responsibilities in Specialty Networks of OptumHealth. We are looking for someone with strong analytical skills, who can think critically. The perfect candidate is detail oriented, yet can see the big picture, can work within and across multidisciplinary teams, build relationships and has a positive personality. We are seeking lifelong learners who stay up to date on regulations, industry trends and advancements in the field, in addition to constantly developing their personal skillset. Our team members are sought out as a valued experts by our case partners, accounts, and customers.

***Required schedule is Monday-Friday, 10:30am - 7:00pm CST***

Primary Responsibilities:

• Extensive work experience, possibly in multiple operational areas.
• Manage a challenging role in a fast - paced environment.
• Achieve timely resolution to urgent and non - urgent issues, most of our issues turn around in 48 hrs.
• Synthesize and communicate complex information in understandable terms both verbally and written.
• Support issue resolution for a variety of internal and external customers.
• Critically analyze issues from multiple angles to determine the root cause and next steps.
• Analyze issues including conducting a root cause analysis by identifying potential compliance, process, or systemic breakdowns and communicate findings to management and issue resolution partners.
• Able communicate effectively with state agencies, regulators, external customers, clinical medical directors, and senior leadership.
• Utilize expertise to support issue resolution.
• Collaborate and coordinate across multiple teams, departments, and representatives.
• Recognize trends with escalated issues and identity, carry out or coordinate preventative action.
• Develop effective working relationships with the applicable internal and external customers.
• Ability to conduct quick and thorough in-depth research across many systems and platforms (Iset, Linx, Unet, Facets, etc.)
• Work independently.
• Mentor and develop other team members.
• Hold others accountable for resolution activities.
• Review the work of others to assess accuracy with process requirements.
• Develop innovative approaches to issue resolution.

This role is challenging but rewarding. The leadership team and colleagues on the team are supportive and will assist you with clear guidance, coaching and direction on what it takes to succeed. Our team and team member are regularly recognized for their performance and the quality of our work.

Required Qualifications:

• Behavioral Health Clinical licensure (i.e., LPC, LCSW, LMFT, LMHC, etc.).
• 5+ years of behavioral health care experience.
• 3+ years of customer service experience in the healthcare industry.
• Knowledge of or State and Federal regulations that govern commercial health insurance.
• Proficiency with computer and Windows PC applications.
• Proficiency with Linx, ICUE, OCM.
• Designated workspace and access to install secure high-speed internet via cable/DSL in home

Preferred Qualifications:

• Experience with or a willingness to learn behavioral health appeals/claims
• Optum Care Advocacy or UM experience
• Assessment and Triage experience

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

California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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. 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.

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.