Behavioral Health Case Manager MSW

UnitedHealth Group • Seattle, WA

229d • $59,500 - $116,600 • Onsite

About The Position

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. The United Healthcare 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.

Requirements

• Master's Degree in Social Work
• Experience working with Microsoft Word, Excel and Outlook

Nice To Haves

• 1+ years of clinical or case management experience
• Experience with electronic charting
• Experience with arranging community resources
• Experience working with complex family systems and dynamics
• Experience in Crisis Intervention
• Experience working in Duals (DSNP) or Medicaid/Medicare environment
• 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
• Knowledge of or the ability to find resources to address SDOH
• 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
• Background in managing populations with complex medical or behavioral needs
• Proven excellent written and verbal communication and relationship building skills
• Proven planning and organizational skills
• Proven ability to work independently as well as a member of a team

Responsibilities

• Makes patient assessments in home setting and determines appropriate levels of behavioral care needed
• Obtains information from providers on outpatient requests for treatment
• Determines if additional clinical treatment sessions are needed
• Manages behavioral health cases throughout the entire treatment plan
• Administers benefits and reviews treatment plans in collaboration with interdisciplinary care team
• Assists in coordinating Medicaid/Medicare benefits and transitions between various areas of care
• Communicates with members who have complex medical needs and may have communication barriers
• Identifies ways to add value to treatment plans and consults with facility staff or outpatient care providers on those ideas
• Focuses on whole person care model for psychiatric and chemical dependency patients
• Builds 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

Benefits

• $7,500 Sign on bonus for External Candidates
• 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