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in Providence, RI

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Hours Full-time, Part-time
Location Providence, RI
Providence, Rhode Island

About this job

You're looking for something bigger for your career. How about inventing the future of health care? Optum 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 part of our continued growth, we are looking for a Field Care Advocate to join our Behavioral Solutions team. If you are looking for a rewarding career where you can use your clinical expertise to make a positive impact in the lives of others, then we have the job for you!



 


The Field Care Advocate will work with members, providers and family members to assist in the coordination of care process as well as interface in person with internal and external business partners.



 


Primary Responsibilities:


 



  • Performing care management activities to ensure that patients move through the continuum of care efficiently and safely

  • Assessing and interpreting customer needs and requirements

  • Reviews cases and analyzes clinical information 

  • Performing Clinician to Physician interaction to acquire additional clinical information or discuss alternatives to current treatment plans

  • Escalates cases to the Medical Director for case discussion or peer-to-peer intervention as appropriate

  • Performs anticipatory discharge planning in accordance with the patient's benefits and available alternative resources

  • Collaborates with Medical peers on consideration of discharge planning needs

  • Refers patients to disease management or case management programs

  • Assists with the development of treatment plans

  • Documents activities according to established standards

  • Identifies solutions to non-standard requests and problems

  • Solves moderately complex problems and/or conducts moderately complex analyses

  • Works with minimal guidance; seeks guidance on only the most complex tasks

  • Provides explanations and information to others on difficult issues

  • Acts as a resource for others with less experience

  • Works with less structured, more complex issues

  • Conducts an assessment of the members health status to assist them in obtaining community based services

  • Focus on community behavioral health and substance abuse services

  • Coordinating benefits and transitions between various areas of care

  • Work with Medicare and Medicaid membership

  • Interface with Health plan and State on a daily bases.

  • Provider Relations and working with Network Manager to fill gaps.

  • Field visits as needed

  • Interface with county court system to maintain court order mental health treatment.

  • Attend meetings with State regularly

Requirements

Required Qualifications:




  • Independently Licensed Master's degree-level clinician in Social Work, Counseling or Psychology or Licensed Ph.D.

  • Licensure must be current and unrestricted  

  • 5 or more years of mental health experience working adults with disability and long term care

  • Demonstrated ability to assist with focusing activities toward a strategic direction as well as developing tactical plans

  • Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action

  • Ability to convey complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others

  • Intermediate computer skills (Microsoft Word, Outlook and Internet) with the ability to navigate a Windows environment and to create, edit, save and send documents utilizing Microsoft Word

  • Ability to work in an ever changing work environment 

  • Dual diagnosis experience with mental health and substance abuse

  • Excellent written and verbal communication skills

 



Preferred Qualifications:




  • Knowledge of Level of Care Guidelines (i.e. Milliman, Interqual etc.)

  • Experience in discharge planning and/or chart review

  • Managed care experience

  • Previous experience in a telephonic, office based role

  • Knowledge of community based Mental Health and substance abuse services for the state of Rhode Island

  • Experience working with patients with Chronic mental illnesses and comorbidity

  • Experience working in an environment that requires coordination of benefits and utilization of multiple groups and resources for patients 

 


 


 


Careers 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)


 




Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.




UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.


 


 


 


 



Job keywords: Nurse, Clinical, RN, LCSW, Social Worker, LMFT, Psychologist, Therapist, Counselor, behavioral health, mental health, Case Management, Utilization Review, Utilization Management, telephonic, work from home, telecommute