IOP Utilization Review Behavioral Health Care Advocate – Telecommute
Posted on: 8 Sep 2022
Dallas, TX
Job Description
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)
As an Utilization Review Behavioral/Mental Health Care Advocate you will be responsible for utilization review of Intensive Outpatient (IOP) 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.
This role is required to work 9:30am to 6:00pm CST or 10:30am to 7:00pm CST. You will have the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:
Focusing on initial and concurrent reviews for psychiatric and chemical dependency patients for Intensive Outpatient (IOP) level of care
Identifying ways to add value to treatment plans and recommending modifications to ensure best practices
Communicating best practice guidelines through clinical discussion with providers
Making patient assessments and determining most appropriate level of care using level of care guidelines or coverage determination guidelines
Telephonically obtaining information from facility representatives on IOP requests for treatment
Determining if additional clinical treatment sessions are needed
Administering benefits and reviewing treatment plans
Coordinating benefits and transitions between various areas of care if indicated
Required Qualifications:
Licensed, independent Master's Degree – Level Clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling, OR Licensed Ph.D., OR an RN with 2+ years of experience in Behavioral Health
Active and unrestricted independent license in your state of residence
2+ years of experience, post Independent Licensure, in a related mental health environment
Outpatient treatment experience
Proficiency with Microsoft Office applications
Ability to work 9:30am to 6:00pm CST or 10:30am to 7:00pm CST
Distraction-free space in home for home office
Access to install secure high-speed internet via fiber optic/cable/DSL in home
Preferred Qualifications:
Experience working in Intensive Outpatient setting
Utilization review and/or management experience
Clinical review to determine appropriate levels of care
Experience consulting with facility and/or hospital staff to coordinate treatment plans
Clinical review to determine medical necessity
Medical or behavioral health collaboration within different organizations
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
UnitedHealth Group
Hopkins, MN
UnitedHealth Group Incorporated operates as a diversified health care company in the United States. It operates through four segments: UnitedHealthcare, OptumHealth, OptumInsight, and OptumRx. The UnitedHealthcare segment offers consumer-oriented health benefit plans and services for national employers, public sector employers, mid-sized employers, small businesses, and individuals; health and well-being services to individuals age 50 and older, addressing their needs for preventive and acute health care services, as well as services dealing with chronic disease and other specialized issues for older individuals; and Medicaid plans, Children’s Health Insurance Program, and health care programs; and health and dental benefits.
The OptumHealth segment provides access to networks of care provider specialists, health management services, care delivery, consumer engagement, and financial services. This segment serves individuals through programs offered by employers, payers, government entities, and directly with the care delivery systems.
The OptumInsight segment offers software and information products, advisory consulting arrangements, and services outsourcing contracts to hospital systems, physicians, health plans, governments, life sciences companies, and other organizations. The OptumRx segment provides pharmacy care services and programs, including retail network contracting, home delivery, specialty and compounding pharmacy, and purchasing and clinical, as well as develops programs in areas, such as step therapy, formulary management, drug adherence, and disease/drug therapy management. UnitedHealth Group Incorporated was founded in 1974 and is based in Minnetonka, Minnesota.
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IndustryHealthcare
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No. of Employees300,000
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Jobs Posted7264
