Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It’s an opportunity to do your life’s best work.(sm)
At OptumHealth, you will perform within an innovative culture that’s focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that’s greater than you’ve ever imagined.
The Strategic Outpatient Engagement & Management (STEM) Care Advocate will complete telephonic clinical reviews directly with Providers to ensure members are getting the most effective and efficient care promoting best practices in the Outpatient psychotherapy and community based treatment setting. Candidates should be able to demonstrate flexibility and be adaptable to change and possess good independent decision making capabilities.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Focus on outpatient Commercial, Medicaid and Medicare behavioral health services
- Conducting outpatient utilization reviews to determine appropriate care
- Assessing if member care meets coverage guidelines
- Shaping member treatment in partnership with providers to ensure best practices
- Administering benefits and reviewing treatment plans
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:
- Active, unrestricted Licensed Master’s Degree – Independent Level Clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling
- Independent licensure
- Outpatient psychotherapy and community based treatment experience
- MS Office proficiency (Word, Excel, Outlook, Internet)
- Must have a distraction-free space in home to use as a home office
- Access to high speed internet (DSL or Cable)
- Available to work hours of 8:30 – 5:00 PM PST, 10:30 – 7:00 PM CST or 9:00 – 6:30 PM EST
Preferred Qualifications:
- Independent license in California, North Carolina, Kentucky, Louisiana, Indiana, Arizona, Washington, Mississippi, or Kansas
- Eligible to be independently licensed in California, North Carolina, Kentucky, Louisiana, Indiana, Arizona, Washington, Mississippi or Kansas
- 2+ years of demonstrated experience (post licensure) in a related mental health environment including outpatient services
- Experience working with EMRs (electronic medical records)
- Experience in managed care
- Experience conducting clinical review to determine appropriate levels of care
- Demonstrated telephonic/office-based experience
- Telephone queue experience
- Utilization review/management experience