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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:




Approximate Salary:

Not Specified

Position Type:

Full Time

Behavioral Health Utilization Management Care Advocate - Telecommute

UHG - Maryland Heights, Missouri

Posted: 12/12/2018

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* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:  
  • 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

Required Qualifications:  
  • Active, unrestricted Licensed Master's Degree - Level Clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling OR Licensed Ph.D., OR an RN with experience in behavioral health
  • 2+ years of demonstrated experience (post licensure) in a related mental health environment including outpatient services
  • 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 10:30am to 7:00pm EST/ 9:30am- 6:00pm CST/ 8:30- 5:00pm MST/ 7:30am- 4:00pm PST
Preferred Qualifications:  
  • 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
  • Experience working with EMRs (electronic medical records)
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.
Job Keywords: Licensed Behavioral Health Care Advocate, Telecommute, telecommuter, Psychology, Social Work, Counseling, Marriage or Family, Ph.D., mental health, work from home, Medicaid, utilization, medical necessity, concurrent review, Optum, Optumhealth

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