Behavioral Health Care Advocate – Hybrid – San Diego County Area

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Due to our ongoing business relationship with the County of San Diego, Optum Behavioral Solutions has an immediate need for a Care Advocate.  As the successful candidate you will focus on clinical review for inpatient, outpatient, and crisis residential authorizations for psychiatric patients.  This is primarily an administrative position with no patient contact. 

***This position is office based in our San Diego, CA office and requires working at least one day in office Monday-Friday, hours of the position are 10:30am to 7pm***

Primary Responsibilities:

• Based on documentation, determining appropriate levels of patient care
• Obtaining information from providers on psychiatric requests for treatment
• Determining if documentation meets medical necessity requirements for payment through Medicaid or the County of San Diego
• Managing inpatient, outpatient, crisis residential mental health cases throughout the entire treatment plan
• Data entry of clinical documentation submitted into the County’s Electronic Health Record or Designated Database 
• Administering benefits and reviewing treatment documentation
• Coordinating benefits and transitions between various levels of care
• Identifying ways to add value to treatment plans and consulting with facility staff or outpatient care providers on those ideas
• Support other sub teams within Utilization Management as needed with authorizations for treatment at Residential Substance Use programs and Long Term Care facilities
• Support the San Diego Access and Crisis Line as needed
• Sign off on paper work products in office from the inpatient hospitals, such as the Treatment Authorization Request

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:

• Licensed, Master’s Degreed 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, Outlook, Teams)
• Live and work within a commutable distance and be willing to work in the San Diego office as needed
• Must be able to obtain and maintain access to the County of San Diego’s electronic health records 

Preferred Qualifications:

• EHR experience
• Experience in a managed care setting
• Dual diagnosis experience in mental health and substance use treatment
• Medi-Cal system experience
• Experience working in an environment that requires coordination of benefits and utilization of multiple groups and resources for patients
• Experience in telephonic roles
• Proven solid data entry skills

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

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.

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.   

OptumCare  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. 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment