Senior Care Advocate, Utilization Management - Remote - Draper, Utah - Remote Eligible

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.

You have high standards. So do we. Here at UnitedHealth Group, this includes offering an innovative new standard for care management. It goes beyond counseling services and verified referrals to programs integrated across the entire continuum of care. That means you'll have an opportunity to make an impact on a huge scale - as part of an incredible team culture that's defining the future of behavioral health care.

If you are licensed in Utah State, you will have the flexibility to work remotely as you take on some tough challenges.

Primary Responsibilities:

• Work with an interdisciplinary clinical team to complete utilization management responsibilities per contracting and other state requirements
• Support day-to-day clinical and utilization management operations to determine service authorizations for Medicaid members
• Complete clinical reviews and utilization management responsibilities that could include inpatient, mental health and substance use disorder higher levels of care, psychological testing, ECT and TMS for adults and youth
• Assess and interpret member treatment needs to support care coordination in collaboration with URs and hospital social workers
• Manage escalated member or customer concerns/cases to resolution
• Engage in enhanced treatment coordination efforts with behavioral health providers, accountable care organizations, and other community stakeholders
• Participate in local agency, provider and other systems staffing to support member treatment needs
• Complete the required documentation in electronic health records
• Potential to participate in inter-department projects to meet development and/or customer goals

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:

• Independently licensed Master's degree level clinician in: Psychology, Social Work, Counseling or Marriage & Family Counseling; OR Licensed Ph.D. or Licensed PsyD; OR an RN with at least 2 years of experience in behavioral health
• Licensure must be current and unrestricted in Utah state or willing to obtain within 30 days of hire
• 3+ years of behavioral health clinical experience in a behavioral health setting including care coordination

Preferred Qualifications:

• Experience in inpatient/acute setting
• Experience with the dually diagnosed patient population
• Utilization review experience in an insurance company or managed care setting
• Experience in discharge planning and/or chart review
• Knowledge of Level of Care Guidelines (LOCUS, CASLOCUS-CASII, ESCII)
• Knowledge of the Medicaid patient population

*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 $71,200 to $127,200 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.