Behavioral Health Case Manager - In Home - Racine or Kenosha, WI

$7,500 Sign-On Bonus for External Candidates

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)

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

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
• 2+ years of experience in long-term care, home health, hospice, public health or assisted living
• 1+ years of clinical or case management experienceor
• Experience working with MS Word, Excel and Outlook
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

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
• 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
• Background in managing populations with complex medical or behavioral needs
• Proficient with Microsoft Word, Excel, Outlook, PowerPoint
• Excellent written and verbal communication and relationship building skills
• Planning and organizational skills
• Ability to work independently as well as a member of a team

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

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.