Job Details

Overview

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 feeltheir best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Join us to start Caring. Connecting. Growing together.

Due to our ongoing business relationship with the County of San Diego, Optum Behavioral Solutions has an immediate need for a Care Advocate. As the successful candidate you will focus on clinical review for inpatient, outpatient, long term care, and crisis/adult residential authorizations for psychiatric patients. This is primarily an administrative position with no patient contact.

100% Telecommute; this position requires working Monday-Friday, standard business hours PST.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities

• Based on documentation, determining appropriate levels of patient care
• Obtaining information from providers on psychiatric or Substance Use Disorder (SUD) requests for treatment
• Determining if documentation meets medical necessity requirements for payment through Medicaid or the County of San Diego
• Managing inpatient, outpatient, long term care, crisis/adult residential mental health cases throughout the entire treatment plan
• Data entry of clinical documentation submitted into the County's Electronic Health Record or Designated Database
• Administering benefits and reviewing treatment documentation
• Coordinating benefits and transitions between various mental health and/or SUD levels of care
• Identifying ways to add value to treatment plans and consulting with facility staff or outpatient care providers on those ideas
• Support other sub teams within Utilization Management as needed with authorizations for treatment at Residential Substance Use programs and Long Term Care facilities
• Support the San Diego Access and Crisis Line as needed

Required Qualifications

• Licensed, Master's Degree Clinician in Psychology, Social Work, Counseling, or Marriage / Family Counseling, a Licensed Ph.D., or an RN with experience in behavioral health
• Licenses must be independent, active and unrestricted in the State of California
• 2+ years of experience in mental health / behavior health environment
• Intermediate level of computer proficiency (including MS Word, Excel, Outlook, Teams)
• Ability to obtain and maintain access to the County of San Diego's electronic health records, SmartCare, Cerner Community Behavioral Health (CCBH), and WITS

Preferred Qualifications

• Experience in a managed care setting
• Experience working in an environment that requires coordination of benefits and utilization of multiple groups and resources for patients
• Experience in telephonic roles
• Dual diagnosis experience in mental health and substance use treatment
• Medi-Cal system experience
• Proven data entry skills

Additional Information

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

Pay is based on several factors including local labor markets, education, work experience, certifications, etc. In addition to salary, benefits include a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (subject to eligibility). The salary range for this role is $58,800 to $105,000 annually for 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 is collected. Job postings 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 everyoneof every race, gender, sexuality, age, location and incomedeserves the opportunity to live their healthiest life. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.

UnitedHealth Group is an Equal Employment Opportunity employer. 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.