Telephonic Social Worker, Optum Care at Home - Colorado
About The Position
Optum Home & Community Care, part of Optum, provides an integrated care model addressing patients’ physical, mental, and social needs. The Optum Care at Home program coordinates clinical care for members in their homes through comprehensive assessments, ongoing visits for higher-risk members, care coordination during transitions, and care management. Its interdisciplinary team provides care both in person and by telephone in collaboration with members’ primary care providers and other care team members. The Behavioral Health Case Manager provides case management and utilization review for behavioral health and substance abuse services. The role coordinates care, supports members in understanding and accessing benefits, and helps ensure appropriate levels of care. It reviews and evaluates inpatient and outpatient behavioral health treatment for medical necessity, emergency status, and quality of care. The position supports members across the Mountain and Pacific time zones; candidates residing in Colorado are strongly preferred and should be flexible in working hours that support members in both regions.
Requirements
- Master of Social Work license, Licensed Clinical Social Worker license, or equivalent state licensure (such as LICSW or LCSW) in the assigned state or market.
- 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 using MS Word, Excel, and Outlook.
- Ability to work with low-income populations with complex social and medical needs, including adults with serious mental illness or emotional disturbances, members with substance use disorders, and members with other complex or multiple chronic conditions.
Nice To Haves
- Experience working with complex family systems and dynamics.
- Experience working in a Duals (DSNP) and/or Medicaid environment.
- Knowledge of symptom identification and intervention associated with behavioral health and substance use disorders.
- Knowledge of APS reporting processes.
Responsibilities
- Conduct telephone assessments to determine the appropriate level of behavioral health care.
- Obtain information from providers about outpatient treatment requests.
- Determine whether additional clinical treatment sessions are needed.
- Manage behavioral health cases throughout the treatment plan.
- Support members in receiving benefits and review treatment plans 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 a variety of community populations.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase.
- 401(k) contribution, subject to eligibility requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
