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 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!