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Behavioral Health Advocate, Utilization Management

2 months ago

New Orleans, United States UnitedHealth Group Full time

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.


As a Facility Based Behavioral Health Care Advocate, you will be responsible for utilization review of behavioral health and substance abuse cases. You'll have a direct impact on the lives of our members as you recommend and manage the appropriate level of care throughout the entire treatment plan.


The selected candidate may choose between working five days/week (9:30 AM - 6 PM CST or 10 AM - 6:30 PST)


If you are a resident of Louisiana and licensed in Louisiana, you will have the flexibility to work remotely* as you take on some tough challenges.


Primary Responsibilities:

  • Focus on initial and concurrent reviews for higher levels of care
  • Inpatient admission for psychiatric and chemical dependency patients via telephone
  • Make patient assessments and determine appropriate levels of care
  • Obtain information from providers on outpatient requests for treatment. Facility Based Care Advocates only work with providers for outpatient request prior to discharge from inpatient, residential and partial levels of care
  • Determine if additional clinical treatment sessions are needed
  • Manage inpatient and outpatient mental health/substance abuse cases throughout the entire treatment plan
  • Administer benefits and reviewing treatment plans
  • Coordinate benefits and transitions between various areas of care
  • Identify ways to add value to treatment plans and consult with facility staff or outpatient care providers on those ideas
  • Oversee the facility based care experience


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:

  • Master's degree in Psychology, Social Work, Counseling, or Marriage or Family Counseling; or Licensed Ph.D
  • Active, unrestricted clinical license to practice independently in the state of Louisiana (LP, LPC, LCSW, or LMFT)
  • 2+ years of post-master's experience in a related behavioral health environment
  • Access to install secure high-speed internet via Cable Broadband, DSL, or Fiber at home
  • Dedicated, distraction-free workspace at home
  • Reside in the state of Louisiana


Preferred Qualifications:

  • Inpatient experience
  • Dual diagnosis experience with mental health and substance abuse
  • Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients
  • Experience working with the Medicaid population
  • Experience working with the Medicare population


*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy


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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and 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.