Field Behavioral Health Case Manager (MSW), Care at Home - Milwaukee, WI
About The Position
Optum Home & Community Care, part of the Optum family of businesses, provides integrated care that addresses patients’ physical, mental, and social needs. The Optum Care at Home team helps patients navigate the health care system and connect with support services so they can remain well at home. The United Healthcare at Home program coordinates clinical care for members in their residences through comprehensive assessments, visits for higher-risk members, care coordination during transitions from hospitals or nursing homes, and ongoing care management. Care is delivered in person and by telephone in collaboration with primary care providers and an interdisciplinary care team. The Behavioral Health Case Manager manages cases and utilization review for behavioral health and substance abuse services. The role includes authorizations, concurrent reviews, coordination, and ensuring members receive appropriate levels of care. It reviews and evaluates inpatient and outpatient behavioral health treatment for medical necessity, emergency status, and quality of care. This is a field-based position in Milwaukee, Wisconsin.
Requirements
- Master’s degree in Social Work.
- At least 2 years of experience in a healthcare setting.
- At least 1 year of clinical or case management experience.
- Experience screening and assessing common behavioral health and/or substance use disorders.
- Experience with electronic charting and Microsoft Word, Excel, and Outlook.
- Driver’s license and access to reliable transportation.
Nice To Haves
- Licensed Master of Social Work, Licensed Clinical Social Worker, or equivalent state licensure (such as LICSW or LCSW) in the assigned state or market.
- Background managing populations with complex medical or behavioral needs.
- Experience arranging community resources.
- Field-based work experience.
- Knowledge of medical and behavioral health diagnoses and terminology.
- Knowledge of symptom identification and intervention related to behavioral health and substance use disorders.
- Knowledge of APS reporting processes.
- Experience working with complex family systems and dynamics.
- Knowledge of resources to address social determinants of health (SDOH).
- Experience in crisis intervention.
- Experience working in a Duals (DSNP) and/or Medicaid environment.
Responsibilities
- Conduct patient assessments at home or by telephone to evaluate and determine the appropriate level of behavioral health care.
- Obtain information from providers regarding outpatient treatment requests.
- Determine whether additional clinical treatment sessions are needed.
- Manage behavioral health cases throughout the treatment plan.
- Administer benefits and review treatment plans in collaboration with the interdisciplinary care team.
- Assist with coordinating Medicaid and Medicare benefits and transitions between areas of care.
- Communicate with members who have complex medical needs and may face communication challenges.
- Identify ways to add value to treatment plans and consult with facility staff or outpatient care providers.
- Provide whole-person care for psychiatric and chemical dependency patients.
- Build relationships and work with varied community populations, including low-income individuals with complex social and medical needs, serious mental illness or emotional disturbances, substance use disorders, and multiple chronic conditions.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs, subject to eligibility requirements.
- Equity stock purchase, subject to eligibility requirements.
- 401(k) contribution, subject to eligibility requirements.
- $7,500 sign-on bonus for external candidates.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
