Telephonic Care Advocate - Multiple Locations

What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in 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.Primary Responsibilities:

Individual contributor – reports directly to the Manager / Senior Manager
Conduct focused outpatient reviews effectively and efficiently; gather consistent clinical information to assess clinical needs, obtain bio-psychosocial data and co-morbid conditions, identify needed resources, and initiate discharge planning
Provide safe, least restrictive care options in order to reduce the need for acute care
Establish and maintain professional working relationships with referral sources, community resources, and care providers and be able to identify and communicate network gaps to appropriate resources
Assist consumers by answering questions, provide 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 liveandworkwell.com 
Administer benefits in compliance with plan inclusions, limitations, and State/Federal mandates
Appropriately identify need for higher level of review such as staffing, peer review or MD consultation; formulate concise case presentations for staffing
Participate in clinical supervision, staff meetings, case conferences, and in-service opportunities
Enter accurate authorizations or notifications
Meet all call and 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 (3 years post-licensure experience preferred)
Minimum two years direct clinical experience with acute and community based psychiatric and chemical dependency treatment in various settings
Computer proficiency with Word, Outlook, and InternetPreferred Qualifications:

Demonstrated familiarity and experience with the current Diagnostic and Statistical Manual and best practice standards for treatment 
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 
Proficiency with Microsoft Office Suite, ability to learn and navigate multiple proprietary software applications; typing proficiency required 
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, efficient and effective 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 environment 
Strong work ethic
Managed care or utilization review experience desirable
Familiarity with recovery and resiliency model   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.
 

Job Keywords: Care Advocate, telephonic, care coordination, Houston, TX, Texas, Chicago, IL, Illinois, Portland, OR, Oregon, St. Louis, MO, Missouri, Atlanta, GA, Georgia