Behavioral Health Escalations Advocate - Remote

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.

The Escalations Advocate is an individual contributor role responsible for an exciting variety of responsibilities in Specialty Networks of Optum Health. Are you a natural problem-solver who thrives on investigating and resolving complex issues? We are looking for someone who is detail oriented yet can see the big picture. We need that rare person who balances solid analytical skills with a positive, team focused personality and one who can support our Elite Advocate4Me behavioral health members in a queue-based environment.

Schedule: Monday - Friday, 10:30am - 7:00pm Central Time Zone.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges

Primary Responsibilities:

• Work in a queue-based environment- providing real time clinical support to our Elite Advocate4Me members
• Genuine passion for improving a member's behavioral health experience
• Assist with behavioral health questions and escalations regarding clinical needs, benefits, referrals, claims, appeals, complaints / grievances, and administrative authorizations
• Ability to assess a members' clinical needs and provide education and referrals to support those needs
• Analyze and communicate complex information in understandable terms to our members in both verbal and written formats
• Ability to investigate and research complex behavioral health related escalations to determine the root cause of the issue and work towards seeking resolution of the issue
• Outreach to members and providers to assist in obtaining information needed to help resolve their issue
• Achieve timely resolution to urgent and non-urgent issue
• Be self-directed, organized and have the ability to work independently
• Act as a resource using clinical knowledge to support and to collaborate with others within the team
• Conduct quick and thorough in-depth research across many systems and platforms (Linx, EnterpriseNow, ISET)

Soft Skills:

• Aptitude to be proactive and resourceful in solving problems to drive towards resolution by leveraging solid critical thinking skills
• Ability to make decisions and develop recommendations independent of established processes (AKA thinking outside the box)
• Leverage inductive reasoning to summarize the key points in fact-based statements when communicating to members, providers, customers, and business partners
• Calm under pressure and make progress in a quick and efficient manner
• Solid interpersonal skills and willingness to collaborate with colleagues across the enterprise
• Ability to research and decipher applicable information from multiple sources and systems
• Feel comfortable driving towards a solution even when the path is not clear
• UHG neutrality - able to balance advocating for members while understanding and representing business needs and processes

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:

• Current and Unrestricted Behavioral Health Independent licensure (i.e., LPC, LCSW, etc.)
• 3+ years of Behavioral Health care experience
• Knowledge of State and Federal regulations that govern commercial health insurance
• Proficiency utilizing a computer and Windows PC applications
• Designated workspace and access to install secure high-speed internet via cable/DSL in home

Preferred Qualifications:

• 3+ years of customer service experience in the healthcare industry
• Supervisory or Team Lead experience
• Experience with Behavioral Health appeals/claims
• Optum Care Advocacy experience
• Proficiency utilizing Linx
• Platform experience in: ISET, UNET, OMNI, EnterpriseNow
• Ability to utilize Microsoft Excel (ability to create, edit, and sort spreadsheets)

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

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

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $58,300 to $114,300 annually. 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.

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.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.