WA, OR, CA, NV, ID, UT, AZ, MT, WY, CO, NM, ND, SD, NE, KS, OK, TX, MN, IA, MO Candidates need to be able to work in the City or State specified – Telecommute
Outpatient Utilization Review Behavioral Care Advocate
Location: Maryland Heights, Missouri United States
Division: OBH AQUA
Contest Number: 816715
Title: Outpatient Utilization Review Behavioral Care Advocate – CST, MST or PST Required
Function: Care Advocacy
Business Segment: Optum Consumer Solutions Group
Region: North America
Country: United States
City: Maryland Heights
Other States: Arizona Colorado New Mexico Utah
Other Cities: Phoenix Colorado Springs Albuquerque Salt Lake City
JobLevel: Individual Contributor
Shift: Day Job
Overtime Status: Exempt
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 Algorithms for Effective Reporting and Treatment (ALERT) Care Advocate will assist with assessment/triage as well as outpatient and concurrent review while managing a broad range of diagnostic patient cases.
You’ll enjoy the flexibility to telecommute in CST, MST or PST time zone as you take on some tough challenges.
Focus on outpatient Medicaid and Medicare behavioral health services
Conducting outpatient utilization 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
Coordinating benefits and transitions between various areas of care
Active, unrestricted Licensed Master’s Degree – Independent Level Clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling
2+ years of demonstrated experience (post-licensure) in a related mental health environment including outpatient services
Experience working with EMRs (electronic medical records)
MS Office proficiency (Word, Excel, Outlook, Internet)
Ability to talk on the phone and type at the same time
Must have a distraction-free space in home to use as a home office
Must have access to high-speed internet (DSL or Cable)
Must be available to work non-negotiable hours of 8:30- 5:00pm MST/ 7:30am- 4:00pm PST
Demonstrated telephonic/office-based experience
Telephone queue experience
Outpatient treatment experience
Utilization review/management experience
Experience working with Medicaid population
Experience in managed care
Experience conducting clinical review to determine appropriate levels of care
Discover a diversified health services and innovation company where data, technology, people and action combine to make great things happen every day – and where every day is another opportunity to do your life’s best work.(sm)
All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Medical & Health , Mental Health