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Licensed Behavioral Health Clinician - Utilization Management Psychiatric Rehabilitation - Remote

Company: UnitedHealth Group
Location: Charlotte
Posted on: November 17, 2023

Job Description:

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. -

As a Utilization Management Care Advocate within the Optum's dedicated Maryland Medicaid Behavioral Health team you will use your clinical skills to conduct initial and concurrent reviews of Behavioral Health services specific to Psychiatric Rehabilitation Programs (PRP).

If you are located in Maryland, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities: -


  • Review both initial and concurrent requests for Psychiatric Rehabilitation Program (PRP) authorizations submitted through a provider portal
  • Obtain additional clinical information from providers on PRP requests for treatment as needed
  • Make patient assessments and determine appropriate levels of care
  • Coordinate transitions between various levels of care


    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: -

    • Independently Licensed Master's degree level clinician in: Psychology, Social Work, Counseling, or Marriage & Family Counseling; OR Licensed Ph.D.; OR Registered Nurse with 3+ years of recent Behavioral Health experience
    • Active, unrestricted, independent license in the state of Maryland (i.e., LCPC, LCSW, LCSW-C, or LCMFT)
    • 2+ years of behavioral health clinical experience in a behavioral health setting, post independent licensure
    • Maryland residence
    • Access to high-speed internet (Cable Broadband, DSL, Fiber Optic)
    • Dedicated, distraction-free workspace at home for home office


      Preferred Qualifications: - - - - - - - - -

      • Telephone queue experience
      • Experience with Medicaid populations
      • Experience with utilization management
      • Knowledge of Maryland Medicaid Level of Care Guidelines
      • Knowledge of public resources throughout Maryland
      • Knowledge of Psychiatric Rehabilitation Program (PRP) guidelines in the state of Maryland
      • Proficient in utilizing MNC in determining appropriate level of care
      • Dual diagnosis experience with mental health and substance abuse
      • Ability to think and act quickly in fast-paced settings
      • Bilingual Spanish


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

        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 employers 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.

Keywords: UnitedHealth Group, Charlotte , Licensed Behavioral Health Clinician - Utilization Management Psychiatric Rehabilitation - Remote, Healthcare , Charlotte, North Carolina

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