Requisition Number: 2356420 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. *** This is a telephonic, queue based position in which you will respond to provider and facility treatment requests, as well as manage and deescalate crisis calls from members *** As a Care Advocate you will be responsible for Utilization Review of mental health and substance use disorder services. You'll have a direct impact on the lives of our members as you recommend and manage the appropriate level of care throughout the entire treatment plan. You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. The hours for this position are Monday - Friday, 8:30 am - 5:30 pm CT and include 1 national holiday per year to be worked. Why Optum Behavioral Care At Optum Behavioral Care, we prioritize clinician well-being, career growth, and innovation in care delivery. We offer a comprehensive benefits and rewards package that may include: - Competitive salary - Generous paid time off - Medical, dental, vision, and behavioral health benefits - 401(k) with company match - Family support and wellness resources - Tuition reimbursement and dedicated learning time - Career development opportunities across a fast-growing organization Primary Responsibilities: - Perform utilization management, utilization review, or concurrent review of behavioral health admissions and continued stay - Ensure that behavioral health care services provided are medically necessary, per standard guidelines - Ensure that behavioral health care services are provided in the most appropriate setting - Integrates a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates the options and services to meet the enrollee's health needs, using education, communication, and all available resources to promote quality, cost-effective outcomes - Discharge planning or management of transitions between care settings to ensure the appropriate services/resources are in place for quality outcomes 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 or doctoral degree in psychology, social work, counseling or related field - Active, unrestricted, independent license in a behavioral health field (i.e., LP, LPC, LPCC, LCSW, LISCW, LMFT, LMHC, etc.) - 3+ years of post-licensure clinical experience in a related behavioral health environment - Proficiency in MS Office Suite - Availability to work 1 national holiday that falls on a weekday per calendar year - Access to install secure, high-speed internet and a dedicated, distraction free workspace at home - Ability to work in a telephonic, queue based position in which you will respond to provider and facility treatment requests, as well as manage and deescalate crisis calls from members Preferred Qualifications: - Licensed Alcohol and Drug Counselor - Managed Care experience - Substance abuse experience - Experience working with children, adolescents, and families - Experience working in a hospital setting - Experience with medical or behavioral health collaboration within different organizations - Proven excellent customer service skills - Proven excellent organizational skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Role Description The Specialty Appeals Pharmacy Care Coordinator fills an integral role in investigating, tracking, and submitting appeals for specialty patients with acute and chronic disease states. In this role, you will be offering appeal assistance to provider offices, tracking appeal letters for submission, obtaining support documents, following up on appeal outcomes, and addressing issues and handling concerns from other corresponding departments. Schedule: - Monday – Friday, will work an 8-hour shift between the business hours of 7am – 7pm CST - Flexibility to telecommute from anywhere within the U.S. Primary Responsibilities: - Communicate with providers, patients, and pharmacy staff to obtain necessary clinical documentation, prior authorization denial letters, and appeal letters. - Access multiple Optum resources to check PA statuses, insurance and appeal outcome statuses and benefits. - Utilization of and proficiency in multiple internal processing systems is required for record keeping, tracking of determinations and potential denied prior authorizations needing an appeal letter/letter of medical necessity. - Complete status checks with provider offices verifying appeal letter receipt and submission to insurance. - Complete status checks with insurances for outcome determination for appeal. - Document case activity, communications, and correspondence in computer system to ensure completeness and accuracy of potential and completed appeal letters. - Facilitate the appeal process between the patient, physician, and insurance company by requesting denial information or additional documentation. - Facilitate obtaining the denial letter from the insurance, patient or physician. - Ensure all clinical information and documentation is obtained. - Process orders to set up patient medication shipment. - Extensive work experience within own function. - Work is frequently completed without established procedures. - Works independently. - May act as a resource for others. - May coordinate others' activities. - Perform other related duties as assigned. Qualifications - High School Diploma/GED - 1+ years of experience in the customer service or healthcare industry - Intermediate level of proficiency with MS Office (Word, Excel, Outlook) - Ability to work independently Monday - Friday, any 8-hour shift between 7am - 7pm CST Requirements - Prior Authorization experience or Appeals experience (Preferred) - Experience in pharmacy or healthcare (Preferred) Benefits - Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays - Medical Plan options along with participation in a Health Spending Account or a Health Saving account - Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage - 401(k) Savings Plan, Employee Stock Purchase Plan - Education Reimbursement - Employee Discounts - Employee Assistance Program - Employee Referral Bonus Program - Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

Role Description Are you a dedicated clinician driven to make a meaningful difference in the lives of children with learning differences? Parallel is seeking expert Speech-Language Pathologists to deliver high-impact, personalized teletherapy. Join our mission-focused team and help empower students and their families with the critical tools they need to thrive and succeed. - Provide student-centered, IEP-aligned virtual speech therapy sessions. - Conduct comprehensive speech-language evaluations leveraging Parallel’s proprietary Clinical Test Library and automated Report Writer. - Partner with multidisciplinary teams to design, monitor, and refine Individualized Education Programs. - Participate in IEP meetings and provide dedicated case management for “Speech Only” students as required. - Systematically track session data and student progress to offer insightful IEP consultations. - Develop detailed, goal-oriented progress reports for each reporting cycle. - Deliver specialized state-specific services, including AAC support, Pre-K interventions, speech screenings, and SLPA supervision. Qualifications - Current ASHA Certificate of Clinical Competence (CCC-SLP). - Minimum of 1 year of full-time school-based experience conducting IEP-directed therapy and evaluations (post-CFY). 2+ years of experience is preferred for case management assignments. - Demonstrated expertise in the IEP process, educational eligibility determinations, and writing comprehensive evaluation reports. - Prior experience with Medicaid billing systems is highly advantageous. - Exceptional communication skills and the ability to build rapport with students from diverse cultural and socioeconomic backgrounds. - Tech-savvy with proficiency in virtual telehealth platforms and digital documentation. - Availability during standard school hours (Monday – Friday, 8:00 am – 4:00 pm). - Multilingual fluency is considered a significant asset. Benefits - Thoughtful Student & District Matching: Alignment with your experience, licensure, and expertise to match you with appropriate districts, schools, and student needs. - Efficient Tools and Support: Access to templates, tools, and streamlined systems designed to reduce administrative paperwork and maintain organization. - Billing & Operational Support: Systems that manage billing and documentation workflows, allowing you to prioritize student support and collaboration. - Clinical Resources: Utilization of standardized assessments, progress monitoring tools, and therapy resources to ensure high-quality service delivery. - Innovation & Feedback: Opportunities for your input to directly shape the future of our programs. - Clinical Community: Connection with peers through dedicated office hours, provider meetings, and free continuing education opportunities offered throughout the school year. - A Powerful Mission: The chance to significantly improve the lives of students nationwide. Company Description Parallel is the first tech-forward provider of care for learning and thinking differences across the United States. We believe learning differences are parallel ways of thinking that should be celebrated. Our mission is to provide students with the resources and encouragement to succeed in the classroom and beyond by helping them build confidence in their unique strengths and create strategies to work around their challenges. - Psychological Assessment - Counseling - Speech-Language Services - Special Education - And more Learn more at parallellearning.com.

Role Description Seeking Telemedicine Family/Internal Medicine Providers. Circle Medical is an adult-only primary care practice committed to the empanelment of primary care providers resulting in high quality, continuity of care for our patients through a telemedicine-first approach. - Evidence-based practice leveraging proprietary, HIPAA-compliant EHR. - Delightful and safe experience for patients and providers via two-way, video-audio appointments. - Pay is fee-for-service; PCPs earn $50 (MD/DO) per patient encounter. - Appointments range from 15 to 30 mins. - Earning potential is limitless with robust incentive programs for top-performing PCPs. - Applicants must reside in the United States of America. - True Primary Care Experience rooted in provider empanelment and continuity of care. - 7-day-a-week operation offering PCPs the freedom to set their own recurring schedules, including evenings and weekends. - Supported by a strong team of patient care advocates and a licensed medical team. - High degree of technical skill utilizing software required. - Open mind to fast-paced improvements driven by product and engineering teams. - In network with most PPO insurance plans. - Help patients understand their coverage so providers can focus on care. Qualifications - Completed an accredited nursing or medical program with a national certification. - Currently licensed in Vermont with the ability to obtain additional state licenses as needed. - Valid Vermont DEA Registration in good standing with all schedules to prescribe medications, including S2. - Ideal candidates will have experience as primary care providers in a clinical setting. - At least 2 years post-residency practice experience is strongly preferred. - Must be Board Certified in Family or Internal Medicine. - Commitment to evidence-based medicine. - Willingness to learn how to diagnose and treat a variety of adult/primary care conditions. - A PC with Windows 11 Pro or a Mac newer than 2020 is required.