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)
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 Strategic Outpatient Engagement & Management (STEM) Care Advocate will complete telephonic clinical reviews directly with Providers to ensure members are getting the most effective and efficient care promoting best practices in the Outpatient psychotherapy and community-based treatment setting. Candidates should be able to demonstrate flexibility and be adaptable to change and possess good independent decision-making capabilities.
If you are located in Pacific or Alaska time zone, you will have the flexibility to telecommute* as you take on some tough challenges.
Focus on outpatient Commercial, 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
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.
Active, unrestricted Licensed Master's Degree - Independent Level Clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling
Outpatient psychotherapy and community-based treatment experience
MS Office proficiency (Word, Excel, Outlook, Internet)
Distraction-free space in home to use as a home office
Access to high speed internet (DSL or Cable)
Resident of Pacific or Alaska Time Zone state
Available to work hours of 8:30-5:00 PM PST or 7:30-4:00 PM AK
2+ years of demonstrated experience (post licensure) in a related mental health environment including outpatient services
Independent license in California, Arizona, Washington, Alaska
Eligible to be independently licensed in California, Arizona, Washington, Alaska
Experience working with EMRs (electronic medical records)
Demonstrated telephonic/office-based experience
Telephone queue experience
Utilization review/management experience
Experience in managed care
Experience conducting clinical review to determine appropriate levels of care
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
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, outpatient, private practice, community, county, Psychology, Social Work, Counseling, Marriage or Family, Ph.D., mental health, work from home, Medicaid, utilization, medical necessity, concurrent review, Optum, OptumHealth, Telecommute, Remote, Work from Home