LTSS Case Manager - Field Based in Fremont and Custer Counties, CO and surrounding areas

UnitedHealth Group•Westcliffe, CO

2h•$24 - $43•Hybrid

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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Position in this function supports corporate objectives by utilizing the demonstrated competency of Long Term Services and Supports to provide Case Management services. Will participate in case conferences with the Supervisor. If you reside locally to Fremont and Custer Counties, CO, you will have the flexibility to work remotely as you take on some tough challenges. This function is for UHC C&S Only (with the exception of the Community Health Worker role). Positions in this function address efforts focused on medical, behavioral, and social determinants of health factors that improve the well-being of individuals, families, and communities. 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.

Requirements

Bachelor’s degree in one of the human behavioral science fields such as human services nursing, social work, psychology, public health
5+ years of relevant experience in the field of LTSS
1+ years of experience with MS Office, including Word, Excel, and Outlook
Reliable transportation and the ability to travel up to 50% within assigned territory to meet with members and providers
Reside locally to Fremont/Custer Counties

Nice To Haves

Experience as a caseworker or case manager with LTSS population, in a private or public social services agency may substitute for the required education on a year for year basis

Responsibilities

Intake/screening/referral, assessment/reassessment, development of support plans, on-going case management, monitoring of the Member’s health and welfare, documentation of contacts and case management activities in the Department-prescribed system, resource development, and case closure
Respect confidentiality and maintain confidence as described in the UHG Employee Handbook and acknowledged through signature by all employees. Maintain confidentiality of patient information. The ability to maintain confidentiality is a critical and essential component of this position
Conduct monitoring contacts as prescribed by the Department. Contact the Member at least once within each quarterly period or more frequently as warranted by the Member’s condition /or as determined by the rules of the LTSS Program in which the Member is enrolled
Conduct face-to-face contact with the Member’s at least every six months or more frequently if warranted by the Member’s condition or the rules of the LTSS Program in which the Member is enrolled. Update the current approved assessment tool and care or support plan in the appropriate documentation system(s) to reflect any changes in condition or services
Complete a new assessment during a face-to-face reassessment annually or more frequently if warranted by the Member’s condition or if required by the rules of the LTSS Program in which the Member is enrolled. Complete additional assessments as needed/required
Monitor the delivery of services and supports identified within the Support Plan and the Prior Authorization Request (PAR)
Attend Department provided training for CMA agencies as well as agency provided in-service and staff development training
Responsible to conduct Work that is in accordance with the CMA Contract Agreement’s requirements. This includes but is not limited to, providing Work that is accurate, timely, and complete
In the event, at any time throughout the case management process, the case manager suspects an individual to be a victim of mistreatment, abuse, neglect, exploitation or a harmful act, the case manager shall immediately refer the individual to the protective services section of the county department of social services of the individual's county of residence and/or the local law enforcement agency
May take on special assignments and projects on an as needed basis. Assist with system assessment and development as needed