Behavioral Health Case Manager - DSNP - Field-Based

Requisition Number: 2393784
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 in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
At Optum Care at Home, we deliver comprehensive, person-centered care to individuals where they live. Our Dual Special Needs Plan (DSNP) program serves adults with complex medical, behavioral health, substance use, and social needs through an integrated interdisciplinary care model. This Washington-based role combines approximately 75% field-based behavioral health case management through in-home member visits across Washington with telephonic support for members in both Washington and Colorado.
The Behavioral Health Case Manager coordinates behavioral health services and supports across medical, behavioral, and community settings. Responsibilities include behavioral health assessments, care planning, treatment coordination, utilization review, level-of-care determinations, and resource navigation. This role helps members access behavioral health, substance use, social service, and benefit resources that support improved outcomes and whole-person health.
Primary Responsibilities:

• Conduct in-home and telephonic behavioral health assessments
• Support individuals with serious mental illness, substance use disorders, co-occurring conditions, chronic illnesses, and complex social needs
• Develop and manage individualized care plans for high-risk members
• Collaborate with behavioral health providers to obtain clinical information and support treatment planning and care coordination activities
• Review behavioral health treatment requests and clinical documentation to support appropriate utilization, medical necessity, quality of care, and level-of-care determinations
• Assess treatment progress and collaborate with providers regarding ongoing treatment needs and service utilization
• Coordinate behavioral health, medical, substance use, and community-based services
• Educate members regarding available Medicaid and Medicare benefits and assist in accessing covered services
• Connect members to LTSS, HCBS, community-based services, and other resources that address health-related social needs
• Support members through transitions from hospitals, skilled nursing facilities, residential treatment, and other care settings
• Collaborate with providers, caregivers, and interdisciplinary team members to support integrated, whole-person care
• Provide crisis assessment, intervention, and coordination with providers and community resources when behavioral health needs escalate
• Document assessments, interventions, care plans, and member interactions in electronic systems

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's degree in social work or related behavioral health field
• Active Washington behavioral health licensure, such as LICSW, LCSW, LMSW, or an equivalent license
• Licensed within the assigned states or ability to obtain additional licensure by start date
• 2+ years in a healthcare setting
• 1+ years of clinical or case management experience
• Experience assessing behavioral health and/or substance use conditions
• Experience with Medicaid Long Term Care, Long-term Services and Supports (LTSS), Home-and Community-Based Services, or a closely related Medicaid care management program
• Ability to travel up to 75% within Washington for in-home member visits
• Valid driver's license and reliable transportation
• Ability to physically navigate home settings, move 30 pounds

Preferred Qualifications:

• Experience supporting DSNP, Medicare Advantage, Medicaid managed care, or similar healthcare programs.
• Experience providing field-based, home-based, or community-based care management.
• Experience working with medically complex, high-risk, or dual-eligible populations.
• Experience with crisis intervention, risk assessment, care transitions, or APS reporting.
• Experience connecting members to community resources and social services.

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.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.