Senior Behavioral Health Care Advocate – Remote Washington

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. Join us to start Caring. Connecting. Growing together. 

 

As a Senior Care Advocate, you will focus on care coordination and all levels of care authorizations for psychiatric and chemical dependency patients and assist teams with data entry and questions. You’ll have a direct impact on the lives of our members as you facilitate care coordination services and assist in the management of authorizations for appropriate levels of care throughout the entire treatment plan.

 

The business hours for this position are between 8:00–5:00PM PST. Position will require flexibility with starting and ending times based on supporting business needs as well as holiday-coverage on a rotating basis. 

 

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

 

Primary Responsibilities:

• Individual contributor (no direct reports) supporting WA Medicaid and DSNP market as dictated by business needs
• Care Management subject matter expert and understanding of Utilization Management process, policies, and cross-team collaboration for dedicated WA Medicaid and DSNP member enrollment
• 2+ years experience in Community Care to include documentation, treatment plan development, and monitoring/auditing Community Care documentation for quality, consistency, and adherence to contractual obligations
• Serve as a resource for staff on routine questions and procedures for Case Management and Utilization Management
• Provide back-up to staff to include member facing interactions for case coverage, escalations, and crisis interventions and safety planning
• Assist with coordination of orientation and training activities
• Provide team and account-specific training to new hires and on-going training to team as needed for coaching opportunities
• Perform quality audits and partner with manager to review key metrics with team
• Provide feedback regarding individual and team performance to management for use in clinical supervision and Performance Reviews
• Participate in scheduled and ad-hoc community partner meetings representing member needs and Health Plan leadership identifying gaps in care and network service needs
• Assist with special projects, committee work, team specific activities and other duties as assigned
• Provide coverage when managers are in meetings or out of the office
• Develop supervisory skills through on-the-job training and supervisor feedback
• Assist in resolution of escalated provider abrasions and member or case issues.
• Collaborate with management teams to ensure effective coordination of cases and proactively identify and resolve issues
• Develop job aids and training documents ensuring quality and consistency in care delivery
• Recommend areas for process improvement and assist with development and implementation of new processes
• May be required to carry Case Management and or Utilization Management case load on limited basis based on business and/or staffing needs to ensure operational readiness for Washington market
• Review patient assessments and determine / recommend appropriate levels of care
• Administer benefits and review treatment plans as needed
• Coordinate benefits and transitions transition of care for members in various areas of care
• Identify ways to add value to treatment plans, authorizations, and organizational initiatives
• Oversee the facility-based and community-based care experience

 

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:

• Licensed master’s degree in psychology, Social Work, Counseling, or Marriage or Family Counseling, Licensed Ph.D., or an RN with 2+ years of experience in behavioral health
• Active, unrestricted clinical license that allows you to practice independently without supervision
• Washington residency and licensure 
• 3+ years experience in a related mental health environment to include Case Management within a Managed Care Organization
• Experience with Case Management and Utilization Review
• Experience providing on the job training (OJT) support to new hires
• Experience training and coaching staff
• Demonstrated experience driving initiatives, improvements, and program implementation
• Proficient Microsoft skills including Teams, Word, Excel, and Outlook
• Demonstrated subject matter expertise (SME) on Case Management care processes and procedures
• Proven ability to meet or exceed performance productivity
• Proven ability to multitask between different systems and cases
• Access to install high-speed internet and a dedicated, distraction-free workspace at home

 

Preferred Qualifications:

• Compact nursing license for RNs
• Dual diagnosis experience with mental health and substance use
• Experience working in an environment that required coordination of services for members, benefits review, and coordination of multiple services and resources for members
• Experience working with multiple lines of business (i.e., Medicare, Medicaid, commercial, etc.)
• Demonstrated familiarity and experience with the current Diagnostic and Statistical Manual and best practice standards for treatment
• Clinical expertise in directing / managing difficult callers through intervention skills while maintaining business appropriate integrity
• Proven ability to maintain comprehensive electronic records

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy 

 

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

 

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.

 

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.   

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and 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.