You're looking for something bigger for your career. How about inventing the future of health care? UnitedHealthcare is offering an innovative new standard for care management. We're going beyond counseling services and verified referrals to behavioral health programs integrated across the entire continuum of care. Our growth is fueling the need for highly qualified professionals to join our elite team. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. Join us. Take this opportunity to start doing your life's best work.(sm) As a Behavioral / Mental Health Care Advocate you will be responsible for case management and 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. What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You will work within 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: Crisis line coverage in rotation with other team members, taking calls from members, providers and others, reviewing clinical data for medical necessity, and authorizing services as appropriate Case load management, to include: reviewing initial and concurrent requests for services, assessing requests and clinical data against medical necessity criteria in guidelines, issuing authorizations, consulting with physicians on denials, and following member cases through to completion, ensuring members receive the care they need, when they need it, in the most appropriate and least restrictive setting Review of members' medical records from providers to determine if mental health and substance abuse services delivered are medically necessary, if they are coordinated with other services and providers, if providers have individualized treatment plans for members, etc. Speaking with members to complete clinical assessments, impact member engagement, assist in care coordination, etc. Work as part of a multidisciplinary team in a company dedicated to Integrated Healthcare in TN
Required Qualifications: Must be an independently licensed Masters - level mental health professional, licensed Ph.D. or registered nurse 2+ years of clinical experience in a related mental / behavioral health setting Proficiency with Microsoft Office Suite, ability to learn and navigate multiple proprietary software applications; typing proficiency Must live within a commutable distance of our Brentwood or Knoxville office locationsPreferred Qualifications: Experience with Medicare / Medicaid members and providers (specific TennCare experience) Familiarity with recovery and resiliency model Previous experience in a managed care environment Experience in an inpatient setting Crisis line or experience with triaging behavioral health crisis calls / situations 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 Bilingual skills Ability to work in a fast - paced, ever - changing office environment and handle change well Ability to work as a member of an integrated healthcare team, internally and externally Ability to multitask between different systems and cases 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 Ability to effectively adapt to a changing environmentCareers 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: 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. Job Keywords: case manager, care advocate, social worker, therapist, counselor, mental health, behavioral health, managed care, substance abuse, inpatient, Medicaid, TennCare, LCSW, LMFT, LPC, RN, registered nurse, Brentwood, Knoxville, Tennessee, TN
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.