Remote Optum Utilization Review Jobs in Texas (NOW HIRING)

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

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 Strategic Outpatient Engagement & Management (STEM) 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. 

***This position is inbound-queue based, and is fully remote, with a Monday-Friday, 10:30am - 7:00pm CST schedule***

You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Focus on outpatient commercial, Medicaid and Medicare behavioral health services  
• Conducting outpatient 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, Independent Level Clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling with 2 years of experience in behavioral health
• Active, unrestricted independent licensure in state of residence
• 2 years of experience in a behavioral health setting
• Outpatient psychotherapy and community-based treatment experience  
• Proven MS Office proficiency (Word, Excel, Outlook, Internet)
• Distraction-free space in home to use as a home office
• Access to high-speed internet (DSL or Cable)

Preferred Qualifications:

• 2 years of demonstrated experience (post licensure) in a related mental health environment including outpatient services
• Experience working with EMRs (electronic medical records) 
• Experience in managed care
• Experience conducting clinical review to determine appropriate levels of care
• Demonstrated telephonic/office-based experience
• Telephone queue experience
• Utilization review/management experience

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.  

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.