Perform pre-certification/prior authorization reviews for behavioral health and substance abuse cases, determine appropriate levels of care, coordinate transitions and discharge planning, consult with facility staff to optimize treatment plans, and identify community-based services throughout the course of care.
Requisition Number: 2364970
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 Utilization Management Behavioral Health Care Advocate you will be responsible for pre-certification / prior authorization 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.
This team does NOT operate in an inbound phone queue environment. This work-from-home position requires a schedule of Monday - Friday, 9:30am to 6:00pm Central Time and working 3 holidays per year based on 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:
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:
Preferred Qualifications:
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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 Utilization Management Behavioral Health Care Advocate you will be responsible for pre-certification / prior authorization 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.
This team does NOT operate in an inbound phone queue environment. This work-from-home position requires a schedule of Monday - Friday, 9:30am to 6:00pm Central Time and working 3 holidays per year based on 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:
- Manage and administer behavioral health benefits for facility-based care
- Utilize clinical assessments to determining appropriate levels of care
- Evaluate if additional clinical services are needed
- Effectively coordinate benefits and transitions between various levels of care
- Identify ways to add value to treatment plans and consult with facility staff to improve outcomes
- Actively assist in identifying appropriate community-based services for discharge planning for the duration of the course of care
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:
- Master's or Doctoral degree in Psychology, Social Work, Counseling, Marriage and Family Therapy, or a related behavioral health discipline
- Active, unrestricted, independent clinical behavioral health license (i.e., LP, LPC, LCSW, LMFT, etc.)
- 2+ years of experience working in a related mental health environment
- Proficiency with Microsoft Office Suite programs including Word, Outlook, and Teams
- Willing to work 3 holidays per year based on business needs
- Ability to adhere to the required schedule of Monday - Friday, 9:30am to 6:00pm Central Time
- Dedicated home office space with access to reliable high speed internet service at home
Preferred Qualifications:
- Experience working at a Managed Care Organization / health insurance company
- Experience working in an inpatient facility
- Experience doing utilization review / utilization management
- Experience completing pre-certification / prior authorization reviews
- Experience working with Commercial, Medicare, and Medicaid lines of business
- Experience working with individuals with co-occurring mental health and substance abuse disorders
- Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients
- Excellent demonstrated verbal and written communication skills
- Proven ability to thrive in a fast-paced environment
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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