Senior Care Advocate - Portland, OR - Full-time / Part-time

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 Senior Care Advocate, you will support the enhancement of integration activities at health plan (HP) patient-centered medical homes and existing behavioral health staff in delivering more effective integrated care. Specifically, this position will be responsible for integrated case management for patients with co-morbid conditions.  In addition the Senior Care Advocate will be responsible for some utilization review of behavioral health and substance abuse services. This includes authorization, concurrent review, and coordination and assurance of appropriate levels of care to members. Further provides case management services through review and evaluation of inpatient and outpatient behavioral health treatments for medical necessity, emergency status, and quality of care.

Primary Responsibilities: 

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  Local clinician dedicated to HP who will serve as a primary contact for high risk and escalated cases
  



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  Identifies medical and behavioral needs, gaps, and obstacles that impede patient improvement 



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  Working in conjunction with the Nurse Case Managers at HP and Optum Care Advocates to coordinate a comprehensive and holistic treatment plan 



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  Partnership with integration team on management of data analysis and/or escalation processes that will determine which members are managed by this team 



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  Provide complex case management in order to help members regain optimum health or improved functional capability, in the right setting and in a cost-effective manner 



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  Oversees a comprehensive assessment of the member's condition; determination of available benefits and resources; and development and implementation of a case management plan with performance goals, monitoring and follow-up 



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  Accountability with Integration Specialist, HP Case Managers and Optum Network Services leaders to address clinical and operational issues with practitioners, as well as identification of network needs and gaps as relate to Care Coordination 



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  Accountability with Integration Specialist and HP Case Managers in the evaluation of and response to outpatient utilization trends
  

Required Qualifications:

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  Must be an independently licensed Masters-level mental health professional, licensed Ph.D. or registered psychiatric nurse.  Must have a current, unrestricted license  



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  Minimum two years direct clinical experience with acute and community based psychiatric and chemical dependency treatment in various settings  
  



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  Must have a minimum of 3 years in a clinical/management role or equivalent managed care experience  



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  Consistently meets or exceeds metrics, deadlines, completes projects, and manages multiple tasks 



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  Minimally 2 years  work experience in Managed care or utilization review experience is mandatory 



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  Demonstrated familiarity and experience with the current Diagnostic and Statistical Manual and best practice standards for treatment  



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  Proficiency with Microsoft Office Suite, ability to learn and navigate multiple proprietary software applications; typing proficiency required  



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  Strong organizational and problem solving skills, and the ability to prioritize and work independently 



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  Strong verbal and written communication skills  



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  Strong interpersonal and critical thinking skills; ability to negotiate and make quick, effective and efficient decisions to resolve cases and issues  



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  Ability and flexibility to assume responsibilities and tasks  and to effectively adapt to a changing environment or when confronted with unforeseen situations 



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  Ability to interact effectively and work cooperatively with a variety of organizations and with   individuals of all professional and non-professional levels 



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  Willingness to work in and contribute to a team-oriented environment both within and between departments 



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  Ability to internalize and apply feedback from manager/supervisor to improve performance and minimize errors  

Preferred Qualifications:

• 3 years post-licensure experience
  


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  Familiarity with recovery and resiliency model
  



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  Medical/Behavioral Setting experience (i.e. hospital, managed care organization, or joint medical/behavioral outpatient practice 



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  Dual diagnosis experience with mental health and substance abuse 



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



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  Clinical training experience 

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, Psychologist, psychiatric, Therapist, Counselor, behavioral health, mental health, Case Management, Utilization Review, Utilization Management, telephonic, Portland, OR, Oregon