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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
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 solid analytical skills with a positive, team – focused personality.
• **Required schedule is Monday-Friday, 10:30am – 7:30pm CST***
Primary Responsibilities:
• Extensive work experience, possibly in multiple operational areas
• Work in a fast – paced, high stress environment
• Achieve timely resolution to urgent and non – urgent issues
• Support and communicate complex information in understandable terms both verbally and written
• Support issue resolution for a variety of internal and external customers
• Critically analyze issues from multiple angles to determine next steps and / or root cause
• Conduct root cause analysis by identifying potential compliance, process, or systemic breakdowns and communicate findings to management
• Able communicate effectively with a state agency, regulator, external customer, or senior leadership
• Utilize business expertise to support issue resolution
• Collaborate and coordinate across multiple teams and departments
• Recognize trends with escalated issues and identity preventative action
• Develop effective working relationships with the applicable internal and external customers
• Ability to conduct quick and thorough in depth research across many systems and platforms (Iset, Linx, Unet, Facets, etc.)
• Work independently
• Mentor and develop other team members
• Hold others accountable for resolution activities
• Review the work of others to assess accuracy with process requirements
• Develop innovative approaches to issue resolution
• Sought out as a valued expert
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:
• Behavioral Health Clinical licensure (i.e. LPC, LCSW, LMFT, LMHC, etc.)
• 5 years of behavioral health care experience
• 3 years of customer service experience in the healthcare industry
• Proven knowledge of State and Federal regulations that govern commercial health insurance
• Proficiency with computer and Windows PC applications
• Proficiency with Linx, iCUE, and/or PULSE
• Designated work space and access to install secure high speed internet via cable/DSL in home
Preferred Qualifications:
• Experience with behavioral health appeals/claims
• Optum Care advocacy experience
• Assessment and triage experience
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
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.
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.
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