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Job Details
$7,500 Sign-on Bonus for External Candidates For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. 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. Primary Responsibilities:
- Make patient assessments in home setting and determining appropriate levels of behavioral care needed
- Obtain information from providers on outpatient requests for treatment
- Determine if additional clinical treatment sessions are needed
- Manage behavioral health cases throughout the entire treatment plan
- Administer benefits and review treatment plans in collaboration with interdisciplinary care team
- Assist in coordinating Medicaid/Medicare benefits and transitions between various areas of care
- Communicate with members who have complex medical needs and may have communication barriers
- Identify ways to add value to treatment plans and consulting with facility staff or outpatient care providers on those ideas
- Focus on whole person care model for psychiatric and chemical dependency patients
- Build 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
- Master’s degree in Social Work
- 2+ years of experience in long-term care, home health, hospice, public health or assisted living
- 1+ years of clinical or case management experience
- Experience working with MS Word, Excel and Outlook
- LMSW or LCSW
- Experience with electronic charting
- Experience with arranging community resources
- Experience in Crisis Intervention
- Experience working in Duals (DSNP) and/or Medicaid environment
- Experience working with complex family systems and dynamics
- Field based work experience
- Background in managing populations with complex medical or behavioral needs
- 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 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
- 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
About the Company
UnitedHealth Group
Minnetonka, MN, United States
UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are... Read more