Behavioral Health Case Manager - Optum at Home - Des Moines IA
Capacity Path, Evansville, IN, United States
About the Program
Optum Home & Community Care, part of the Optum 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 Care at Home team, together in an interdisciplinary care environment, 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. This life‑changing work adds a layer of support to improve access to care. We’re connecting care to create a seamless health journey for patients across care settings. Join us to start
Caring. Connecting. Growing together.
Program Overview
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.
Position Overview
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.
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
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 experience
Experience working with MS Word, Excel and Outlook
Driver's License and access to reliable transportation
Preferred Qualifications
Proven background in managing populations with complex medical or behavioral needs
Experience with electronic charting
Experience with arranging community resources
Field based work experience
Proven knowledge of both Medical and Behavioral Health Diagnosis and terminology
Proven knowledge of symptom identification and intervention, associated with Behavioral Health and Substance Use disorders
Proven knowledge of APS reporting processes
Experience working with complex family systems and dynamics
Proven knowledge of resources to address SDOH
Experience in Crisis Intervention
Demonstrated 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
Experience working in Duals (DSNP) and/or Medicaid environment
Proficient with Microsoft Word, Excel, Outlook, PowerPoint
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.
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Optum Home & Community Care, part of the Optum 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 Care at Home team, together in an interdisciplinary care environment, 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. This life‑changing work adds a layer of support to improve access to care. We’re connecting care to create a seamless health journey for patients across care settings. Join us to start
Caring. Connecting. Growing together.
Program Overview
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.
Position Overview
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.
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
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 experience
Experience working with MS Word, Excel and Outlook
Driver's License and access to reliable transportation
Preferred Qualifications
Proven background in managing populations with complex medical or behavioral needs
Experience with electronic charting
Experience with arranging community resources
Field based work experience
Proven knowledge of both Medical and Behavioral Health Diagnosis and terminology
Proven knowledge of symptom identification and intervention, associated with Behavioral Health and Substance Use disorders
Proven knowledge of APS reporting processes
Experience working with complex family systems and dynamics
Proven knowledge of resources to address SDOH
Experience in Crisis Intervention
Demonstrated 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
Experience working in Duals (DSNP) and/or Medicaid environment
Proficient with Microsoft Word, Excel, Outlook, PowerPoint
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.
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