Utilization Management Care Advocate Job at UnitedHealth Group
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do
your life's best work.(sm)
As a Behavioral Health Utilization Management Care Advocate within the Optum’s dedicated Maryland Medicaid Behavioral Health team you will use your clinical skills to conduct initial and concurrent reviews of Behavioral Health services specific to substance use disorder. You will work interdependently with internal teams, external partners, and vendors in a manner consistent with the highest levels of performance and professionalism to accomplish critical tasks. As a key resource, your positive approach and dedication to teamwork will enable you to provide outstanding assistance. This position provides a great opportunity to have an impact on the lives of our participant as you recommend and manage the appropriate level of care.
If you live in the state of Maryland, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
- Guide telephonic reviews, obtain relevant clinical information from behavioral health providers, review treatment plans, determine appropriate levels of care, and administer public behavioral health benefits
- Review written requests for authorizations submitted through a provider portal
- Oversee initial and continued stay requests for authorization to inpatient and outpatient psychiatric, substance use, and dual diagnosis treatment services
- Coordinate transitions between various levels of care
- Telephonic assessment and triage of participants in behavioral health crisis
Required Qualifications:
- Master's Degree in Psychology, Social Work, Counseling or Marriage or Family Counseling; Licensed Ph.D.; OR Registered Nurse with Behavioral Health Experience
- Clinically independent active and unrestricted license in the state of Maryland LP, LCSW, LCMFT, LCPC or RN (RN must have 3+ years of recent behavioral health experience)
- 2+ years of experience in behavioral health, post independent licensure
- Access to high-speed internet (Cable Broadband, DSL, Fiber Optic with internet speed requirement of 13MBPS/20MBPS) and a dedicated, distraction-free workspace from home
Preferred Qualifications
- Knowledge of Maryland Medicaid Level of Care Guidelines
- Knowledge of public resources throughout Maryland
- Proficient in utilizing ASAM in determining appropriate level of care
- Experience with Medicaid populations
- Experience with utilization management
- Dual diagnosis experience with mental health and substance abuse
- Solid problem-solving skills
- Telephone queue experience
- Bilingual Spanish
Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $53,300 to $95,100. The salary range for Connecticut/Nevada residents is $58,800 to $104,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
*All Telecommuters 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 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.
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