Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere.
As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home.
We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.
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The Optum at Home program is a longitudinal, integrated care delivery program that coordinates the delivery and provision of clinical care of members in their place of residence. The DSNP program combines UHC trained clinicians providing intensive interventions customized to the needs of each individual, in collaboration with the Interdisciplinary Care Team. United providers serve patients in their own homes through annual comprehensive assessments, ongoing visits for higher risk members, care coordination during transitions from the hospital or nursing home and ongoing care management. The program's interdisciplinary care team approach provides needed care in person and through telephonic interventions in collaboration with the members Primary Care Provider and other members of the interdisciplinary care team.
The Behavioral Health Case Manager is responsible for case management and utilization review of behavioral health and substance abuse services. The case management includes authorization, concurrent review, and coordination and assurance of appropriate levels of care to members. This position provides case management services through review and evaluation of inpatient and outpatient behavioral health treatments for medical necessity, emergency status, and quality of care.
Primary Responsibilities:
- Make patient assessments in home setting and determining appropriate levels of behavioral care needed
- Obtain information from providers on outpatient requests for treatment
- Determine if additional clinical treatment sessions are needed
- Manage behavioral health cases throughout the entire treatment plan
- Administer benefits and review treatment plans in collaboration with interdisciplinary care team
- Assist in coordinating Medicaid/Medicare benefits and transitions between various areas of care
- Communicate with members who have complex medical needs and may have communication barriers
- Identify ways to add value to treatment plans and consulting with facility staff or outpatient care providers on those ideas
- Focus on whole person care model for psychiatric and chemical dependency patients
- Build relationships and work with a variety of populations within the community
- Ability to work with low - income populations with complex social and medical needs including adults with serious mental illness and emotional disturbances, members with substance use disorders, and members with other complex or multiple chronic conditions
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 Degree in Social Work or Licensed Mental Health Worker
- Clinical licensure in OK
- 2+ years of experience in long-term care, home health, hospice, public health or assisted living
- 1+ years of clinical or case management experience
- Experience working with MS Word, Excel and Outlook
- Ability to travel at 50%
Preferred Qualifications:
- A background in managing populations with complex medical or behavioral needs
- Experience with electronic charting
- Experience with arranging community resources
- Prior field-based work experience
- Knowledge of both Medical and Behavioral Health Diagnosis and terminology
- Knowledge of symptom identification and intervention, associated with Behavioral Health and Substance Use disorders
- Knowledge of APS reporting processes
- Experience working with complex family systems and dynamics
- Knowledge of resources to address SDOH
- Experience in Crisis Intervention
- Understanding of health disparities among various membership, based on their race or ethnicity; religion; socioeconomic status; sexual orientation; gender, gender identity; age; mental health; cognitive, sensory or physical disability; geographic location or other characteristics historically linked to discrimination and exclusion
- Experience working in Duals (DSNP) and/or Medicaid environment
- Excellent written and verbal communication and relationship building skills
- Planning and organizational skills
- Proficient with Microsoft Word, Excel, Outlook, PowerPoint
- Ability to work independently as well as a member of a team
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.