Behavioral Health Escalation Advocate - Remote
About the position Responsibilities • 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 • 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 identify preventative action • Develop effective working relationships with applicable internal and external customers • Conduct quick and thorough in-depth research across many systems and platforms • 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 • Be sought out as a valued expert Requirements • 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 Nice-to-haves • Experience with behavioral health appeals/claims • Optum Care advocacy experience • Assessment and triage experience Benefits • Comprehensive benefits package • Incentive and recognition programs • Equity stock purchase • 401k contribution