Behavioral Health Care Advocate (Utilization Management) – KY License Required

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.  

As a Behavioral Health Care Advocate, you’ll complete prior authorizations and concurrent reviews for mental health and substance use disorder treatments, including inpatient, partial and residential levels of care. Requests are received through digital faxes. 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.

***This position is 100% remote, with a Monday – Friday, 8:00am – 5:00pm CST schedule.***

If you have a Kentucky license, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Manage facility-based admissions for mental health and substance abuse through the continuum of care
• Effectively collaborate with treating providers and facilities to ensure consumers are receiving treatment in line with best practice and level of care guidelines
• Effectively communicate with consumers about their benefit coverage and provide appropriate resources and referrals
• Make decisions about appropriate levels of care based on medical necessity guidelines

You’ll find the pace fast and the challenges ongoing. We’ll expect you to achieve and document measurable results. You’ll also need to think and act quickly while working with a diverse member population.  

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; Licensed Ph.D., or Registered Nurse with 2+ years of experience in behavioral health
• Active, unrestricted clinical license to practice independently in the state of Kentucky
• 2+ years of behavioral health experience
• Facility-based mental health / substance abuse experience
• Proficient in Microsoft Office (Word, Excel, Outlook, and Teams)
• Dedicated home office space and access to install secure high-speed internet in home (Cable Broadband, DSL, or Fiber)

Preferred Qualifications:

• Inpatient experience
• Experience working in a managed care setting
• Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients
• Experience using ICUE
• Experience using Linx
• Demonstrated understanding of ASAM and/or LOCUS criteria
• Proven solid time management skills
• Proven ability to work independently, effectively, and collaboratively within in a fast paced, changing environment
• Proven solid verbal and written communication skills

*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.

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. 

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