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Senior Behavioral Health Care Advocate - Hybrid Remote in San Diego
For those who want to invent the future of health care, here's your opportunity. We're going beyond counseling services and verified referrals to behavioral health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)
Due to our ongoing business relationship with the County of San Diego, Optum Behavioral Solutions has an immediate need for a CA licensed Senior Care Advocate. As a Senior Care Advocate, you will focus on authorizations for psychiatric and chemical dependency patients and supporting the larger Utilization Management (UM) team with data entry and questions. There are multiple clinical sub teams within UM, which work collaboratively to ensure business needs are met: Inpatient, Crisis Residential, Outpatient, Long Term Care (LTC), and Substance Use Disorder (SUD). This is primarily an administrative position with no patient contact.
*This position allows for mostly remote work, but does require working at least one day per week in the San Diego office. Schedule is Monday-Friday, 10:30am-7:00pm *
- Based on documentation, determining appropriate levels of patient care
- Obtaining information from providers on authorization requests for treatment
- Determining if documentation meets medical necessity requirements for payment through Medicaid or the County of San Diego
- Managing mental health and/or SUD cases throughout the treatment episode
- Administering benefits and reviewing treatment documentation
- Coordinating benefits and transitions between various areas of care
- Identifying ways to add value to treatment plans and consulting with facility staff or outpatient care providers on those ideas
- Data entry of clinical documentation submitted into the County’s Electronic Health Record or Designated Database
- Assist other teammates and/or other sub teams within Utilization Management as needed with questions, data entry, guidance, and support
- Monitor and oversee sub team workload and arrange coverage as needed and/or cover as needed
- Support implementation of any new requirements and current policies, procedures, and processes or assist in updating current processes and creation of new processes
- Assist leadership with projects, running reports and updates as needed
- Attend weekly leadership meetings
- Take initiative to assist other team members with their workloads and support the team
- Assist Supervisor with various tasks for business needs and serve as liaison with other departments
- Assist in interviewing, onboarding and training of new hires
- Ensure all work products are covered and turnaround times met for the sub team and/or the larger Utilization Management team
- Assist with problem resolution as needed
- Participate in Quality Assurance activities as needed and delegated
- Provide feedback to Manager or Supervisor on opportunities for improvement of the department or operations
- Knowledge of outcome focused clinical models and interventions in mental health and SUD
- Strong written and verbal communication and customer services skills
- Ability to work autonomously
- May serve as back up to other Senior Care Advocates across the larger team
- Serve as key point of contact for external stakeholders, providers and County staff as needed
- Support Access and Crisis Line as needed
- Model positive, professional and solution-oriented attitude
- Other duties as assigned
- Independently licensed, Master's Degree level Clinician in Psychology, Social Work, Counseling, or Marriage / Family Counseling, a Licensed Ph.D., or an RN with experience in behavioral health
- Licenses must be independent, active and unrestricted in the State of California.
- 2+ years of experience in mental health / behavior health environment.
- Intermediate level of computer proficiency (including MS Word/Excel/Office/Outlook/Teams)
- Ability to work a Monday-Friday, 10:30am-7:00pm schedule, with at least one day per week onsite in the San Diego office, depending on business needs.
- Strong computer skills; must be able to type and talk at the same time in addition to navigating a Windows environment.
- You will be required to be granted and maintain access to the County of San Diego’s electronic health record Cerner Community Behavioral Health and other electronic databases.
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.
- Previous supervisory, Subject Matter Expert or Team Lead experience
- Cerner or WITS experience
- Experience in a managed care setting
- Dual diagnosis experience with mental health and substance use treatment
- Medi-Cal system experience
- Experience working in an environment that requires coordination of benefits and utilization of multiple resources for patients
- Experience in telephonic roles
- Strong data entry and presentation skills
- Experience in Utilization Management
- Experience with high risk psychiatric or SUD patients working in community settings such as psychiatric inpatient, LTC, or SUD treatment
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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: 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.
- Electronic Medical Record
- Diseases And Disorders
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