At OptumHealth, you will perform within an innovative culture that’s focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that’s greater than you’ve ever imagined. The Algorithms for Effective Reporting and Treatment (ALERT) Care Advocate will complete telephonic clinical reviews directly with Providers to ensure members are getting the most effective and efficient care promoting best practices in the Outpatient psychotherapy and community based treatment setting. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Focus on outpatient Medicaid and Medicare behavioral health services Conducting outpatient utilization reviews to determine appropriate care Assessing if member care meets coverage guidelines Shaping member treatment in partnership with providers to ensure best practices Administering benefits and reviewing treatment plans 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: Active, unrestricted Licensed Master’s Degree – Independent Level Clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling Independent licensure Outpatient psychotherapy and community based treatment experience MS Office proficiency (Word, Excel, Outlook, Internet) Must have a distraction-free space in home to use as a home office Must have access to high speed internet (DSL or Cable) Must be available to work hours of 9:30- 6:00 PM CST or 10:30 – 7:00 PM CST Preferred Qualifications: 2 years of demonstrated experience (post licensure) in a related mental health environment including outpatient services Independent license in Kentucky or Ohio Experience working with EMRs (electronic medical records) Demonstrated telephonic/office-based experience Telephone queue experience Utilization review/management experience Experience in managed care Experience conducting clinical review to determine appropriate levels of care Discover a diversified health services and innovation company where data, technology, people and action combine to make great things happen every day – and where every day is another opportunity to do your life’s best work.(sm) All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. 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. Job Keywords: Licensed Behavioral Health Care Advocate, outpatient, private practice, community, county, telecommute, telecommuter, Psychology, Social Work, Counseling, Marriage or Family, Ph.D., mental health, work from home, Medicaid, utilization, medical necessity, concurrent review, Optum, Optumhealth Job Details Requisition Number Job Title Outpatient Utilization Review Behavioral Care Advocate Telecommute Job Family Behavioral Business Segment Optum Consumer Solutions Group Job Location Information Cleveland, OH United States North America Additional Job Detail Information Employee Status Regular Schedule Full-time Job Level Individual Contributor Shift Day Job Travel No Telecommuter Position Yes Overtime Status Exempt