Behavioral Health Escalation Advocate - Remote

The Escalations Advocate is an individual contributor role responsible for an exciting variety of responsibilities in Specialty Networks of OptumHealth. We are looking for someone who is detail - oriented,yet can see the big picture. We are in need of that rare person who balances strong analytical skills with a positive, team - focused personality.

Will be working 8:30 AM – 5:00 PM or 9:30 AM – 6:00 PM in your time zone

Primary Responsibilities:

• Critically analyze issues from multiple angles to determine next steps and / or root cause
• Sought out as a valued expert
• Able communicate effectively with a state agency, regulator, external customer, or senior leadership
• Support issue resolution for a variety of internal and external customers
• Conduct root cause analysis by identifying potential compliance, process, or systemic breakdowns and communicate findings to management
• Ability to conduct quick and thorough in depth research across many systems and platforms (Iset, Linx, Unet, Facets, etc.)
• Mentor and develop other team members
• Support and communicate complex information in understandable terms both verbally and written
• Achieve timely resolution to urgent and non - urgent issues
• Utilize business expertise to support issue resolution
• Extensive work experience, possibly in multiple operational areas
• Recognize trends with escalated issues and identity preventative action
• Develop effective working relationships with the applicable internal and external customers
• Develop innovative approaches to issue resolution
• Collaborate and coordinate across multiple teams and departments
• Hold others accountable for resolution activities
• Review the work of others to assess accuracy with process requirements
• Work in a fast - paced, high stress environment
• Work independently

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:

• Proficiency with Linx, iCUE, and / or PULSE
• Proficiency with computer and Windows PC applications
• Behavioral Health Clinical licensure (ie. LPC, LCSW, etc)
• Have a designated work space and access to install secure high speed internet via cable/DSL in home
• 3+ years of customer service experience in the healthcare industry
• Knowledge of State and Federal regulations that govern commercial health insurance
• 5+ years of Behavioral Health care experience

Preferred Qualifications:

• Prior Optum Care Advocacy experience
• Experience with Behavioral Health appeals / claims
• Assessment and triage experience