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Behavioral Health Utilization Sr. Care Advocate - PST, Weekends - Remote

Company: UnitedHealth Group
Location: Miami
Posted on: September 15, 2023

Job Description:

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.--

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.--
*** Candidate must be willing and able / available to work Saturday and Sunday from 7:00 am - 5:30 pm PST and alternating holidays ***

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

Primary Responsibilities:

  • Utilize advanced clinical skills to complete behavioral health medical necessity reviews
  • Review cases and analyze clinical information in conjunction with medical directors to determine the appropriateness of hospitalization
  • Manage escalated concerns/cases to resolution
  • Participate in standing meetings to review performance, identify areas of opportunity, and oversee course for improvements
  • Meet all contractual requirements; collaborate early and frequently with other teams in the management of cases stratified as having intensive, complex, and high-risk needs
  • Comply with all policies, procedures and documentation standards in appropriate systems, tracking mechanisms and databases
  • Collaborate with providers to determine acuity of mental health concerns, barriers and progress; coordinate appropriate services
  • Provide telephonic support to members in a behavioral health crisis, assess risk for safety, provide consultation, treatment recommendation, and resources
    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
    • Licensure must be current and unrestricted in the State of Nevada
    • 3+ years of behavioral health clinical experience in a behavioral health setting
    • 2+ years of experience in behavioral health
    • 1+ years of experience working within a Managed Care Organization (MCO)
    • Willing and able to work Saturday and Sunday from 7am - 5:30pm PST and alternating holidays

      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 (i.e., MCG, InterQual, etc.)
      • Knowledge of the Medicaid patient population

        California, Nevada, or Washington Residents Only: The hourly range for California, Nevada, or Washington residents is $32.60 to $63.99. 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 employees working remotely 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.

Keywords: UnitedHealth Group, Miami , Behavioral Health Utilization Sr. Care Advocate - PST, Weekends - Remote, Healthcare , Miami, Florida

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