Behavioral Health Case Manager- Care at Home- Jackson, MS

Posted Yesterday
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Jackson, MS, USA
In-Office
60K-107K Annually
Junior
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Provides behavioral health case management and utilization review for patients receiving care at home. Conducts behavioral health assessments, determines appropriate care levels, reviews treatment plans for medical necessity, coordinates Medicaid and Medicare benefits, manages transitions across care settings, and collaborates with interdisciplinary teams, providers, patients, and community resources. Supports psychiatric and substance-use populations with complex medical and behavioral needs.
Summary Generated by Built In
Requisition Number: 2396554
$7500 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 in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
The Care at Home (CAH) Dual Special Needs Plan (DSNP) program is a longitudinal, integrated care delivery program that coordinates the delivery and provision of clinical care of patients (beneficiaries) in their place of residence. The CAH program combines Optum trained clinicians providing intensive interventions customized to the needs of everyone, in collaboration with the Interdisciplinary Care Team, comprised of the Care at Home team of clinicians as well as community-based health care professionals (e.g., PCP, specialists, behavioral health, pharmacy, and other providers). Optum providers serve people in their own homes through annual evaluations, longitudinal visits for higher risk beneficiaries, care coordination during transitions from the hospital or nursing home, and ongoing care management
The Behavioral Health Case Manager is responsible for case management and utilization review of behavioral health and substance abuse services. Case management includes authorization, concurrent review, and coordination and assurance of appropriate levels of care to patients. 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 determine 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 patients who have complex medical needs and may have communication barriers
  • Identify ways to add value to treatment plans and consult 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

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 or Licensed Mental Health Worker
  • 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

Preferred Qualifications:
  • A background in managing populations with complex medical or behavioral needs
  • Experience with electronic charting
  • Experience with arranging community resources
  • Prior 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
  • Experience working with complex family systems and dynamics
  • Knowledge of resources to address SDOH
  • Experience in Crisis Intervention
  • 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
  • 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

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 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are 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.
UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • Master’s degree in Social Work or Licensed Mental Health Worker qualification
  • 2+ years of experience in long-term care, home health, hospice, public health, or assisted living
  • 1+ year of clinical or case management experience
  • Experience with Microsoft Word, Excel, and Outlook
  • Experience managing populations with complex medical or behavioral needs
  • Experience with electronic charting
  • Experience arranging community resources
  • Prior field-based work experience
  • Knowledge of medical and behavioral health diagnoses and terminology
  • Knowledge of symptom identification and intervention for behavioral health and substance-use disorders
  • Knowledge of APS reporting processes
  • Experience working with complex family systems and dynamics
  • Knowledge of resources addressing social determinants of health
  • Experience in crisis intervention
  • Understanding of health disparities among diverse populations
  • Experience working in Dual Eligible Special Needs Plan or Medicaid environments
  • Proficiency with Microsoft Word, Excel, Outlook, and PowerPoint
  • Excellent written and verbal communication and relationship-building skills
  • Planning and organizational skills
  • Ability to work independently and as part of a team

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Leave & Time Off Breadth — PTO is generally described as decent or good, and many note it as a strong part of the package. Actual ability to take time off can depend on workload and team coverage.
  • Retirement Support — Offerings include a 401(k) with employer match and access to an employee stock purchase plan, which are highlighted as meaningful components of total rewards. These programs are consistently referenced among core benefits.
  • Parental & Family Support — Parental and caregiver leave, along with adoption assistance, are publicly highlighted and viewed as notable elements of the package. Availability can be role-specific, but these supports contribute to overall breadth where offered.

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, 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. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
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