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Behavioral Health Care Advocate - UM (remote In CA) - Remote Eligible

Assess medical necessity and determine appropriate care levels during inbound calls
Fresno, California, United States
Junior
$58,800 – 105,000 USD / year
2 days ago
UnitedHealth Group

UnitedHealth Group

A diversified health and well-being company offering a broad spectrum of products and services through two distinct platforms: UnitedHealthcare and Optum.

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Caring. Connecting. Growing Together.

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.

If you are located in California, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • Responsible for handling inbound calls, from providers and members in a call center / cue based environment
  • Conduct initial clinical assessments and determine appropriate levels of care, based on medical necessity
  • Explain and administer benefits according to plan descriptions for all levels of care (OP, IOP, PHP, RTC, IP)
  • Ability to quickly assess and meet time sensitive deadlines within the Utilization management setting
  • Ability to manage and resolve complex or escalated callers/issues in fast paced environment

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 degree in psychology, Social Work or Marriage and Family Therapy, LPCC, or PhD/PsyD
  • Clinical license in LCSW, LMFT, LPCC that is active and unrestricted in the state of California
  • 2+ years of experience in behavioral health
  • Live in and be a legal resident of California for the duration of employment
  • Ability to work 8:30am-5pm PST
  • Ability to work rotating holidays
  • Dedicated office space and access to high-speed internet service in your home

Preferred Qualifications:

  • Dual diagnosis experience with mental health and substance abuse
  • Experience in working in an environment that required coordinating benefits and utilizing various resources to meet patient needs
  • Experience with utilizing computer applications and softphone to complete all primary work responsibilities
  • Proficiency in Microsoft Office Suite Program (Word, Teams, Outlook, Excel, etc.)

*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 $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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Behavioral Health Care Advocate - UM (remote In CA) - Remote Eligible
Fresno, California, United States
$58,800 – 105,000 USD / year
Remote
About UnitedHealth Group
A diversified health and well-being company offering a broad spectrum of products and services through two distinct platforms: UnitedHealthcare and Optum.