Behavioral Health Case Manager - DSNP - Field-Based

UnitedHealth Group•Seattle, WA

6d•$60,200 - $107,400•Hybrid

About The Position

Optum Home & Community Care, part of the Optum 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 Care at Home team, together in an interdisciplinary care environment, 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. This life-changing work adds a layer of support to improve access to care. We’re connecting care to create a seamless health journey for patients across care settings. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together. At Optum Care at Home, we deliver comprehensive, person-centered care to individuals where they live. Our Dual Special Needs Plan (DSNP) program serves adults with complex medical, behavioral health, substance use, and social needs through an integrated interdisciplinary care model. This Washington-based role combines approximately 75% field-based behavioral health case management through in-home member visits across Washington with telephonic support for members in both Washington and Colorado. The Behavioral Health Case Manager coordinates behavioral health services and supports across medical, behavioral, and community settings. Responsibilities include behavioral health assessments, care planning, treatment coordination, utilization review, level-of-care determinations, and resource navigation. This role helps members access behavioral health, substance use, social service, and benefit resources that support improved outcomes and whole-person health.

Requirements

Master’s degree in social work or related behavioral health field
Active Washington behavioral health licensure, such as LICSW, LCSW, LMSW, or an equivalent license
Licensed within the assigned states or ability to obtain additional licensure by start date
2+ years in a healthcare setting
1+ years of clinical or case management experience
Experience assessing behavioral health and/or substance use conditions
Experience with Medicaid Long Term Care, Long-term Services and Supports (LTSS), Home-and Community-Based Services, or a closely related Medicaid care management program
Ability to travel up to 75% within Washington for in-home member visits
Valid driver's license and reliable transportation
Ability to physically navigate home settings, move 30 pounds

Nice To Haves

Experience supporting DSNP, Medicare Advantage, Medicaid managed care, or similar healthcare programs.
Experience providing field-based, home-based, or community-based care management.
Experience working with medically complex, high-risk, or dual-eligible populations.
Experience with crisis intervention, risk assessment, care transitions, or APS reporting.
Experience connecting members to community resources and social services.

Responsibilities

Conduct in-home and telephonic behavioral health assessments
Support individuals with serious mental illness, substance use disorders, co-occurring conditions, chronic illnesses, and complex social needs
Develop and manage individualized care plans for high-risk members
Collaborate with behavioral health providers to obtain clinical information and support treatment planning and care coordination activities
Review behavioral health treatment requests and clinical documentation to support appropriate utilization, medical necessity, quality of care, and level-of-care determinations
Assess treatment progress and collaborate with providers regarding ongoing treatment needs and service utilization
Coordinate behavioral health, medical, substance use, and community-based services
Educate members regarding available Medicaid and Medicare benefits and assist in accessing covered services
Connect members to LTSS, HCBS, community-based services, and other resources that address health-related social needs
Support members through transitions from hospitals, skilled nursing facilities, residential treatment, and other care settings
Collaborate with providers, caregivers, and interdisciplinary team members to support integrated, whole-person care
Provide crisis assessment, intervention, and coordination with providers and community resources when behavioral health needs escalate
Document assessments, interventions, care plans, and member interactions in electronic systems