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.In this role you will have the ability to achieve work life balance. Flexible scheduling offered where providers can flex their time over the 7-day work week. No on-call, no weekends and no holidays required.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. This is a Monday-Friday, 8:00am-5:00pm EST.This position will be working in the field the majority of the time with some work at home time.We would like someone who is in or close to New Hyde Park, NY.If you are located in New York, you'll enjoy the flexibility to work remotely *as you take on some tough challenges. 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
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. Required Qualifications:
- Master' Degree in Social Work (MSW)
- 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
- Must be able to travel in designated territory within New York state
Preferred Qualifications:
- 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) and/or Medicaid 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 resources to address SDOH
- Background in managing populations with complex medical or behavioral needs
- 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
- Proficient with Microsoft Word, Excel, Outlook, PowerPoint
- 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
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
New York Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.