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Sr Behavioral Health Clinical Auditor

Company: UnitedHealth Group
Location: Dallas
Posted on: May 28, 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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)

Optum Provider Performance is an integrated team serving all Optum businesses. We're focused on improving the health of our members, enhancing our operational effectiveness, and reinforcing brand and reputation for high-quality health plans. Join us and help guide our efforts to improve the patient experience. It takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment.

This position requires residency in the state of Louisiana and will require travel up to 75% of the month within the state, including overnights. We are looking to hire for several new openings and some ideal locations would be New Orleans, Baton Rouge, Shreveport, Lafayette and Monroe Lousiana. -

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

Primary Responsibilities:

  • Complete clinical audits and record reviews of behavioral health and substance use disorder providers in the State of Louisiana
  • Provide education and support to providers regarding operational and treatment record documentation standards
  • Conduct quality of care investigations of behavioral health and substance use disorder providers
  • Provide analytical support and expertise when compiling report information
  • Develop and implement effective analysis, research, and evaluation in preparation for clinical monitoring audits activities
  • Assume responsibility for inter-rater reliability of clinical audit activities
  • Participate in departmental meetings and activities
  • Travel 75% of work month, including overnight travel

    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:

    • Master's Degree or Ph.D. leading to an independent behavioral health licensure
    • Active, unrestricted, Independent Mental Health Licensure (i.e., LP, LCSW, LMFT, or LPC)
    • 3+ years of behavioral health experience
    • Travel 75% of work month, including overnight travel
    • Intermediate computer skills (Microsoft Word, Excel, Outlook, and Internet) with the ability to navigate a Windows environment, including create, edit, save, and send documents using Microsoft Word
    • When working from home, you must have access to high-speed internet and a dedicated, distraction-free workspace at home
    • Access to reliable transportation that will enable you to travel up to 75% of the month, including overnights, to client and/or patient sites within the state of Louisiana

      Preferred Qualifications:

      • Experiencing conducting clinical audits of behavioral health/substance use disorder treatment records
      • Experience with Medicaid service delivery
      • Knowledge of Joint Commission survey processes
      • Knowledge of HEDIS Standards
      • Knowledge/experience with behavioral health Evidence-Based Practices
      • Knowledge of inpatient and substance use disorder programs
      • Ability to collect, analyze, and present data

        Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

        ---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 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.

Keywords: UnitedHealth Group, Dallas , Sr Behavioral Health Clinical Auditor, Healthcare , Dallas, Texas

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