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UnitedHealth Group

Behavioral Health Advocate, Medicare Case Management - Telecommute

UnitedHealth Group - Aurora, CO

Position Description You're looking for something bigger for your career. How about inventing the future of health care? UnitedHealthcare is offering an innovative new standard for care management. We're going beyond counseling services and verified referrals to behavioral health programs integrated across the entire continuum of care. Our growth is fueling the need for highly qualified professionals to join our elite team. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. Join us. Take this opportunity to start doing your life's best work. (sm) As a Behavioral Health Advocate, you will be responsible for case management and utilization review of behavioral health and substance abuse cases. You'll have a direct impact on the lives of our members as you recommend and manage the appropriate level of care throughout the entire treatment plan. What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You will work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Focus of Case Management is to engage the consumer in their own recovery process and to empower them to access services within the community to increase their community tenure Identify and examine gaps and other determinants of readmission to higher levels of care facility Successfully reach out to consumers within 30 days of discharge from facility-based care to ensure engagement in the follow-up program Develop and implement recovery plans with consumers focusing on strengths and personal goals; identify gaps in care and provide referrals to resources to address those gaps Educate and encourage consumers to utilize self-directed treatment and Personal Advanced Behavioral Health Directive Assist consumers by answering questions, providing program information and education about care coordination program services, network and community resources and coverage determination guidelines Identify available resources and promote use of educational materials and web-based information including As appropriate consult with family members, employers, health plan, existing providers, and primary care physicians regarding patients' treatment needs and goals and to provide proper coordination of care Collaborate with providers and consumers to define precipitants, symptoms, recovery and resiliency needs, desired outcomes and interventions, and discuss appropriate levels of care placement based on clinical presentation and risk factors Support outcome-focused, evidenced-based best practices and guidelines with providers Provide consultation to providers and/or consumers on a variety of issues including benefit information, safety issues, confirmation of prior authorizations/ approvals, procedures for higher level of care evaluations, and requests for an explanation of the level of care, coverage determination, or best practice guidelines Establish and maintain professional working relations with referral sources, community resources, and care providers and be able to identify and communicate network gaps to appropriate resources Appropriately identify need for higher level of review such as staffing, peer review or MD consultation; formulate concise case presentations for staffing Administer benefits in compliance with plan inclusions, limitations, and State / Federal mandates Participate in clinical supervision, staff meetings, case conferences, and in-service opportunities Enter accurate authorizations or notifications Meet all documentation audit standards Adhere to schedule as assigned Comply with HIPAA regulations Effectively collaborate with other departments to meet consumer needs Perform other duties as assigned Required Qualifications: Must be an independently licensed Masters-level mental health professional, licensed Ph.D. or registered psychiatric nurse Must have a current, unrestricted license 2 years direct clinical experience Demonstrated familiarity and experience with the current Diagnostic and Statistical Manual and best practice standards for treatment Proficiency with Microsoft Office Suite Ability to learn and navigate multiple proprietary software applications Typing proficiency Knowledge of or ability to research and connect with community resources, including ability to utilize features of search engines as well as Intranet to discern available resources for any caller Preferred Qualifications: 3 years post-licensure experience Familiarity with recovery and resiliency model Managed care or utilization review experience Strong organizational and problem solving skills, and the ability to prioritize and work independently Ability to multitask between different systems and cases Strong verbal and written communication skills Ability to maintain comprehensive electronic records Strong interpersonal and critical thinking skills; ability to negotiate and make quick effective and efficient decisions to resolve cases and issues Clinical expertise in directing / managing difficult callers through intervention skills while maintaining business appropriate integrity Ability to effectively adapt to a changing environmentCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy 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. Job Keywords: LCSW, LISW, LMFT, LP, Social Worker, Therapist, Counselor, Case Manager, Care Advocate, Care Navigator, Social Worker, Therapist, Counselor, Managed Care, Behavioral Health, Mental Health, Optum, Telecommute, Telecommuting, Remote, WFT

11 days 16 hours ago

UnitedHealth Group


Behavioral Health Advocate, Medicare Case Management - Telecommute UnitedHealth Group - Aurora, CO, United States


Location: Aurora, CO

Company Profile:
About UnitedHealth Group UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone. We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term