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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity 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 requires working a schedule of Monday-Friday, 10:30am - 7:00pm Pacific Time. Partial Remote (telecommute)/work from home opportunities (3-4 days per week remote) will be allowed based on business needs***

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 with 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
  

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)
• Ability to obtain and maintain access to the County of San Diego’s electronic health records, Anasazi and WITS
• Reside in the state of CA and be willing to work in the San Diego office as needed
  

Preferred Qualifications:

• Cerner 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
  

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

California Residents Only: The salary range for California residents is $56,300 to $110,400. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

*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.

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.