Remote Senior Behavioral Health Care Advocate

Requisition Number: 2191088
Job Category: Behavioral
Primary Location: Eden Prairie, MN
(Remote considered)

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 and 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. 

As a Senior Care Advocate, you will focus on inpatient authorizations for psychiatric and chemical dependency patients and assist teams with data entry and questions. You’ll have a direct impact on the lives of our members as you recommend and manage the appropriate level of care throughout the entire treatment plan.

The business hours for this position are between 7:00 AM – 6:00 PM CST. Position will require flexibility with starting and ending times based on supporting business needs.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities: 

• Individual contributor (no direct reports) supporting multiple teams and supervisors as dictated by business needs
• Facility-based care subject matter expert
• Serve as a resource for staff on routine questions and procedures
• Assist with coordination of orientation and training activities
• Provide team and account-specific training to new hires and on-going training to team as needed
• Perform quality audits and partner with manager to review key metrics with team
• Provide feedback regarding individual and team performance to management for use in clinical supervision and Performance Reviews
• Assist with special projects, committee work, team specific activities and other duties as assigned
• Provide coverage when managers are in meetings or out of the office
• Develop supervisory skills through on-the-job training and supervisor feedback
• Assist in resolution of escalated member or case issues
• Collaborate with management teams to ensure effective coordination of cases and proactively identify and resolve issues
• Develop job aids and training documents
• Recommend areas for process improvement and assist with development and implementation of new processes
• Maintain a 50% caseload based on business needs and priorities
• Complete initial concurrent reviews for higher levels of care (i.e., Inpatient, Residential and Partial hospital admissions) across all lines of business
• Determine if additional clinical treatment sessions are needed through managing and/or staffing cases
• Review patient assessments and determine / recommend appropriate levels of care
• Administer benefits and review treatment plans as needed
• Coordinate benefits and transitions between various areas of care
• Identify ways to add value to treatment plans
• Oversee the facility-based care experience

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: 

• Licensed Master’s degree in Psychology, Social Work, Counseling, or Marriage or Family Counseling, Licensed Ph.D., or an RN with
• Active, unrestricted clinical license that allows you to practice independently without supervision
• 2+ years of experience in behavioral health
• 2+ years of post-masters experience in a related mental health environment
• Experience with Utilization Review
• Experience providing on the job training (OJT) support to new hires
• Experience training and coaching staff
• Experience handling calls in a queue, inbound or outbound
• Demonstrated experience driving initiatives and improvements
• Demonstrated subject matter expertise (SME) on facility-based care processes and procedures
• Proven ability to meet or exceed performance productivity
• Proven ability to multitask between different systems and cases
• Proficient Microsoft skills including Teams, Word, Excel, and Outlook
• Access to install high-speed internet and a dedicated, distraction-free workspace at home

Preferred Qualifications:

• Compact nursing license for RNs
• Dual diagnosis experience with mental health and substance abuse
• Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients
• Experience working with multiple lines of business (i.e., Medicare, Medicaid, commercial, etc.)
• Call center experience
• Demonstrated familiarity and experience with the current Diagnostic and Statistical Manual and best practice standards for treatment
• Clinical expertise in directing / managing difficult callers through intervention skills while maintaining business appropriate integrity
• Proven ability to maintain comprehensive electronic records

California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $67,800 to $133,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

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