Behavioral Health Case Manager, LCSW, RN or CPC

UnitedHealth Group • Las Vegas, NV

95d • $58,800 - $105,000 • Remote

About The Position

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Behavioral Health Case Manager will be responsible for the management and coordination of Case Management services for members with complex needs and requiring complex service. The Outpatient Case Manager works directly with the member, provider(s), facilities, and other entities to ensure the most appropriate care is provided. The Case Manager manages members from all contracted product lines. The Case Manager assesses, plans, implements, coordinates, monitors, and evaluates the outcomes, ensuring options and services required to meet the member's health needs are best utilized. The Case Manager provides education, advocacy, communication, and resource management and promotes quality, self-management, and cost-effective interventions and outcomes.

Requirements

• Current, unrestricted LCSW, RN, LMFT or CPC license
• Nevada state license
• 2+ years of behavioral health experience
• 2+ years of case management experience
• Intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word

Nice To Haves

• CCM certification or ability to obtain within 2 years of employment
• 2+ years of utilization review experience
• Knowledge of patient care delivery in a managed care environment
• Basic knowledge of both state programs and the community-based services

Responsibilities

• Perform Member assessment of all major domains using evidence-based criteria (behavioral, physical, functional, financial and psychosocial)
• Assess, plan and implement care plan strategies that are individualized by Member and directed toward the most appropriate, least restrictive level of care, to achieve recovery and adaptive functioning and monitor progress toward their goals
• Utilize both company and community-based resources to establish a safe and effective case management plan for Members
• Collaborate with Member, family, and health care providers (PCP, BH Providers) to develop an individualized plan of care and supportive services for members
• Support and coordinate Member behavioral health services and integrated substance use disorder treatment, supporting medication management, symptoms management, rehabilitation, crisis stabilization, and psychosocial education on an outpatient basis
• Provide advocacy, health education, coaching, referrals and treatment decision support for Members and their caregivers
• Meet with Members via telephone or in the community (in their home, at their providers' office, community settings or at inpatient facilities) if requested, deemed appropriate, or warranted
• Document activities according to established standards and ensure files meet NCQA/Medicaid requirements
• Accountable to understand role and how it affects utilization management benchmarks and quality outcomes
• Understand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health plan
• Takes in-bound calls and places out-bound calls as dictated by Member and business needs
• Special projects, initiatives, and other job duties as assigned

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Master's degree