Behavioral Health Escalations Advocate - Remote
About the position
The Behavioral Health Escalations Advocate is an individual contributor role within Optum Health, responsible for providing clinical support to members in a queue-based environment. This position focuses on resolving complex behavioral health issues, assisting members with their clinical needs, and ensuring a positive experience for those seeking help. The role requires strong analytical skills, a detail-oriented approach, and the ability to communicate effectively with members and providers.
Responsibilities
Provide real-time clinical support to Elite Advocate4Me members in a queue-based environment.
,
Assist with behavioral health questions and escalations regarding clinical needs, benefits, referrals, claims, appeals, complaints/grievances, and administrative authorizations.
,
Assess members' clinical needs and provide education and referrals to support those needs.
,
Analyze and communicate complex information in understandable terms to members in both verbal and written formats.
,
Investigate and research complex behavioral health-related escalations to determine root causes and seek resolutions.
,
Outreach to members and providers to obtain information needed to help resolve issues.
,
Achieve timely resolution to urgent and non-urgent issues.
,
Work independently while being self-directed and organized.
,
Act as a resource using clinical knowledge to support and collaborate with team members.
,
Conduct thorough research across various systems and platforms.
Requirements
Current and Unrestricted Behavioral Health Independent licensure (i.e., LPC, LCSW, etc.)
,
3+ years of Behavioral Health care experience
,
Knowledge of State and Federal regulations governing commercial health insurance
,
Proficiency in utilizing a computer and Windows PC applications
,
Designated workspace with secure high-speed internet access.
Nice-to-haves
3+ years of customer service experience in the healthcare industry
,
Supervisory or Team Lead experience
,
Experience with Behavioral Health appeals/claims
,
Optum Care Advocacy experience
,
Proficiency utilizing Linx
,
Experience with ISET, UNET, OMNI, EnterpriseNow
,
Ability to utilize Microsoft Excel for creating, editing, and sorting spreadsheets.
Benefits
Comprehensive benefits package
,
Incentive and recognition programs
,
Equity stock purchase
,
401k contribution
Apply Now
The Behavioral Health Escalations Advocate is an individual contributor role within Optum Health, responsible for providing clinical support to members in a queue-based environment. This position focuses on resolving complex behavioral health issues, assisting members with their clinical needs, and ensuring a positive experience for those seeking help. The role requires strong analytical skills, a detail-oriented approach, and the ability to communicate effectively with members and providers.
Responsibilities
Provide real-time clinical support to Elite Advocate4Me members in a queue-based environment.
,
Assist with behavioral health questions and escalations regarding clinical needs, benefits, referrals, claims, appeals, complaints/grievances, and administrative authorizations.
,
Assess members' clinical needs and provide education and referrals to support those needs.
,
Analyze and communicate complex information in understandable terms to members in both verbal and written formats.
,
Investigate and research complex behavioral health-related escalations to determine root causes and seek resolutions.
,
Outreach to members and providers to obtain information needed to help resolve issues.
,
Achieve timely resolution to urgent and non-urgent issues.
,
Work independently while being self-directed and organized.
,
Act as a resource using clinical knowledge to support and collaborate with team members.
,
Conduct thorough research across various systems and platforms.
Requirements
Current and Unrestricted Behavioral Health Independent licensure (i.e., LPC, LCSW, etc.)
,
3+ years of Behavioral Health care experience
,
Knowledge of State and Federal regulations governing commercial health insurance
,
Proficiency in utilizing a computer and Windows PC applications
,
Designated workspace with secure high-speed internet access.
Nice-to-haves
3+ years of customer service experience in the healthcare industry
,
Supervisory or Team Lead experience
,
Experience with Behavioral Health appeals/claims
,
Optum Care Advocacy experience
,
Proficiency utilizing Linx
,
Experience with ISET, UNET, OMNI, EnterpriseNow
,
Ability to utilize Microsoft Excel for creating, editing, and sorting spreadsheets.
Benefits
Comprehensive benefits package
,
Incentive and recognition programs
,
Equity stock purchase
,
401k contribution
Apply Now