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...
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 Job!
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 Job!
