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Behavioral Health Care Advocate - Brentwood or Knoxville - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Brentwood, TN Brentwood, Tennessee |
About this job
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)
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.
To get better insight to this role and determine if it is the right fit for you, click here to view the Realistic Job Preview: http: //uhg.hr/SocialWorkerRJP
The Behavioral Health Care Advocate is responsible for case management and utilization review of behavioral health and substance abuse services, including authorization, concurrent review, and coordination and assurance of appropriate levels of care to members. Specific responsibilities of this role may include:
- Crisis line coverage in rotation with other team members, taking calls from members, providers and others, reviewing clinical data for medical necessity, and authorizing services as appropriate.
- Case load management, to include: reviewing initial and concurrent requests for services, assessing requests and clinical data against medical necessity criteria in guidelines, issuing authorizations, consulting with physicians on denials, and following member cases through to completion, ensuring members receive the care they need, when they need it, in the most appropriate and least restrictive setting. (Some of this work may be onsite at provider agencies/facilities)
- Review of members' medical records from providers (or onsite at the provider agencies) to determine if mental health and substance abuse services delivered are medically necessary, if they are coordinated with other services and providers, if providers have individualized treatment plans for members, etc.
- Meeting with members face to face (in a variety of settings) to complete clinical assessments, impact member engagement, assist in care coordination, etc.
- Work as part of a multidisciplinary team in a company dedicated to Integrated Healthcare in TN.
Requirements
The requirements for this role are as follows:
- Master's degree or higher with a concentration in social work, psychology or other mental/social health discipline with current TN State licensure (LCSW, LMFT, LPC, etc.) as an independently licensed clinician in good standing OR RN with Current TN State licensure in good standing, with Bachelor's Degree or higher and a minimum of 3 years behavioral health experience
- 3+ years clinical experience resulting in the ability to differentially diagnose
- Computer proficiency in MS Office suite
Additional assets include:
- Experience with Medicare / Medicaid members and providers (specific TennCare experience a plus)
- Ability to work in a fast-paced, ever-changing office environment and handle change well
- Managed Care exposure
- Ability to work as a member of an integrated healthcare team, internally and externally.
- Crisis line or experience with triaging behavioral health crisis calls/situations
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, 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.
Keywords: LCSW, LPC, LMFT, RN, behavioral health, Medicaid, Medicare, TennCare, behavioral assessment, crisis line, managed care