Behavioral Health Care Advocate - Utilization Management - Remote In Missouri

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 Behavioral / Mental Health Care Advocate you will be responsible for case management and utilization review of Behavioral Health and substance abuse cases. 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.  

What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the Health Care system. You will work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. 

***This is a remote position in the state of Missouri***

  
Primary Responsibilities: 

• Perform Utilization Management, utilization review, or concurrent review of Behavioral Health admissions and continued stay
• Determine appropriateness of inpatient and outpatient services following evaluation of designated guidelines
• Ensure that Health Care services provided are medically necessary
• Ensure that Health Care services are provided in the most appropriate setting
• Manage medical benefits resources effectively and efficiently while ensuring quality care is provided
• Complete patient assessments and determining appropriate levels of care
• Facility Based Care Advocates only work with providers for inpatient request prior to discharge, residential and partial levels of care
• Manage inpatient and outpatient (Intermediate Levels of Care, i.e.: Residential and Partial) mental health/substance abuse cases throughout the entire treatment plan
• Administer benefits and review treatment plans
• Identify ways to add value to treatment plans and consulting with facility staff

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, or Licensed Ph.D., or an RN with 2 years of experience in Behavioral Health
• Licenses must be active and unrestricted in the State of Missouri
• 2 years of experience in a related mental health environment
• Proficient Microsoft Office Applications (Word, Excel, Outlook, Teams) with the ability to navigate between multiple systems
• Permanent residence in the state of Missouri
• Private home workplace with access to reliable high-speed internet

Preferred Qualifications:         

• Utilization management experience
• Experience in an inpatient setting
• Dual diagnosis experience with mental health and substance abuse
• Experience working in an environment that required coordination of benefits
• Proven ability to apply clinical expertise when discussing case with internal and external Case Managers and Physicians

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

   
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.    
 
  
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employers 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