Behavioral Health Care Advocate (Utilization Review, Outpatient)
About the position 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. 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. This position is inbound-queue based, and is fully remote, with a Monday-Friday, 10:30am - 7:00pm schedule. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Responsibilities • Focus on outpatient commercial, Medicaid and Medicare behavioral health services • Conducting outpatient 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 Requirements • Active, unrestricted, Independent Level Clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling, or an RN with 2+ years of experience in behavioral health • Active, unrestricted licensure • 2+ years of experience in a behavioral health setting • Outpatient psychotherapy and community-based treatment experience • Proven 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) Nice-to-haves • Licensure in the state of Kansas or Kentucky is highly preferred • 2+ years of demonstrated experience (post licensure) in a related mental health environment including outpatient services • Experience working with EMRs (electronic medical records) • Experience in managed care • Experience conducting clinical review to determine appropriate levels of care • Demonstrated telephonic/office-based experience • Telephone queue experience • Utilization review/management experience Benefits • Comprehensive benefits package • Incentive and recognition programs • Equity stock purchase • 401k contribution Apply tot his job