Behavioral Health Escalation Advocate - Remote

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

Job summary

A global healthcare organization is seeking a Behavioral Health Escalation Advocate to manage operational responsibilities in Specialty Networks. This remote role requires strong analytical skills and a deep understanding of behavioral health care, offering comprehensive benefits and opportunities for growth.

Benefits

Comprehensive benefits packages

Incentives

Stock options

401k

Opportunities for growth and development

Qualifications

• 5+ years of behavioral health care experience.
• 3+ years of healthcare customer service experience.
• Knowledge of relevant regulations and proficiency with computer applications.

Responsibilities

• Manage operational roles and resolve issues within a 48-hour turnaround.
• Synthesize and communicate complex information clearly.
• Conduct root cause analysis and communicate findings.

Skills

Analytical Skills

Critical Thinking

Attention to Detail

Communication

Collaborative Skills

Education

Behavioral Health Clinical Licensure (e.g., LPC, LCSW, LMFT, LMHC) or RN with Psychiatric Experience

Job description

Join to apply for the Behavioral Health Escalation Advocate - Remote role at Optum.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need. We foster a culture guided by inclusion, talented peers, comprehensive benefits, and career development opportunities. Make an impact on communities as you help us advance health on a global scale. Join us to start Caring. Connecting. Growing together.

The Escalations Advocate is a role responsible for handling responsibilities in OptumHealth's Specialty Networks. We seek someone with strong analytical skills, critical thinking, attention to detail, and the ability to work within multidisciplinary teams. Continuous learning about regulations, industry trends, and personal skill development is essential. Our team members are valued as experts by our partners, accounts, and customers.

This position offers the flexibility to work remotely from anywhere in the U.S.

Primary Responsibilities

• Manage operational roles and resolve issues within a 48-hour turnaround.
• Synthesize and communicate complex information clearly both verbally and in writing.
• Support issue resolution for internal and external customers.
• Conduct root cause analysis and communicate findings.
• Effectively communicate with agencies, regulators, and leadership.
• Collaborate across teams and recognize trends for preventative actions.
• Develop relationships with customers and conduct research across systems.
• Work independently, mentor others, and review work for accuracy.
• Develop innovative issue resolution approaches.

The role is challenging but rewarding, with supportive leadership and recognition for performance. Opportunities for growth and development are provided.

Required Qualifications

• Behavioral Health Clinical licensure (e.g., LPC, LCSW, LMFT, LMHC) or RN with psychiatric experience.
• 5+ years of behavioral health care experience.
• 3+ years of healthcare customer service experience.
• Knowledge of relevant regulations and proficiency with computer applications.

Preferred Qualifications

• Experience with behavioral health appeals/claims, advocacy, assessment, and triage.

Salary ranges from $58,800 to $105,000 annually, based on experience and location. Benefits include comprehensive packages, incentives, stock options, and 401k. The application will be posted for at least 2 days or until enough candidates are collected.

Our mission is to help people live healthier lives and address health disparities, with a commitment to equity and environmental responsibility. We are an Equal Opportunity Employer and a drug-free workplace.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Healthcare Provider