Behavioral Health Care Advocate - Utilization Review, Outpatient - Remote

Posted 2025-08-23
Remote, USA Full Time Immediate Start
<p><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">The Optum family of businesses, is seeking a Behavioral Health Care Advocate to join our team. As a member of the Optum Behavioral Care team, you’ll be an integral part of our vision to make healthcare better for everyone.</span></span><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">&nbsp;</span></span></p>
<p style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">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.</span></span><span style="font-family: tahoma, arial, helvetica, sans-serif; font-size: 10px;">&nbsp;</span></p>
<p style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">The Strategic Outpatient Engagement &amp; 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. </span></span></p>
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<p style="font-family: Tahoma; text-align: center;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><strong>***This position is inbound-queue based, and is fully remote, with a Monday-Friday, 10:30am - 7:00pm schedule***</strong></span></span></p>
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<p style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">You’ll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.</span></span></p>
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<p style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><strong>Primary Responsibilities:</strong></span></span></p>
<ul>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Focus on outpatient commercial, Medicaid and Medicare behavioral health services &nbsp;</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Conducting outpatient reviews to determine appropriate care</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Assessing if member care meets coverage guidelines</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Shaping member treatment in partnership with providers to ensure best practices</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Administering benefits and reviewing treatment plans</span></span></li>
</ul>
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<p style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">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.</span></span></p><br><br><p><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><strong>Required Qualifications:</strong></span></span></p>
<ul>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Active, unrestricted, Independent Level Clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling, or an RN with 2+ years of experience in behavioral health</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Active, unrestricted licensure in your state of residence</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">2+ years of experience in a behavioral health setting</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Outpatient psychotherapy and community-based treatment experience &nbsp;</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Proven MS Office proficiency (Word, Excel, Outlook, Internet)</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Distraction-free space in home to use as a home office</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Access to high-speed internet (DSL or Cable)</span></span></li>
</ul>
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<p style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><strong>Preferred Qualifications:</strong></span></span></p>
<ul>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Licensure in the state of Kansas or Kentucky&nbsp;</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">2+ years of demonstrated experience (post licensure) in a related mental health environment including outpatient services</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience working with EMRs (electronic medical records)&nbsp;</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience in managed care</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience conducting clinical review to determine appropriate levels of care</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Demonstrated telephonic/office-based experience</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Telephone queue experience</span></span></li>
<li style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Utilization review/management experience</span></span></li>
</ul>
<p style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">&nbsp;</span></span></p>
<p style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><strong>Explore opportunities at Optum Behavioral Care.</strong> We’re revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We’re connecting care to create a seamless health journey for patients across care settings. Join our team, it’s your chance to improve the lives of millions while <strong>Caring. Connecting. Growing together. </strong></span></span></p>
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<p style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.</span></span></p>
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<p style="font-family: Tahoma;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.&nbsp;</span></span></p>
<p><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.</span></span></p>
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<p style="font-family: Tahoma; text-align: center;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><em>At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.</em></span></span><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><em>&nbsp;</em></span></span></p>
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<p style="font-family: Tahoma; text-align: center;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><em>UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.</em></span></span></p>
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<p style="font-family: Tahoma; text-align: center;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><em>UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.</em></span></span></p>
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