Optum Care 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 Optum Care at Home trained clinicians providing intensive interventions customized to the needs of each individual, in collaboration with the Interdisciplinary Care Team. Optum 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 coordination of care, support for member needs with awareness of benefits, 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 role supports members across the Mountain and Pacific time zones. Candidates residing in Colorado are strongly preferred and should have the flexibility to work hours that effectively support members in both regions.
Primary Responsibilities:- Conduct patient assessments via telephone to evaluate and determine the appropriate level of behavioral health care required
- 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
- Support member to receive 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 face challenges in communication
- 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
- 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:- Licensed Master of Social Work, Licensed Clinical Social Worker or equivalent state licensure (e.g.: LICSW, LCSW) in assigned state/market
- 2+ years in a healthcare setting
- 1+ years of clinical or case management experience
- Experience with screening and assessment of common behavioral health and/or substance use disorders
- Experience working with MS Word, Excel and Outlook
Preferred Qualifications:- Experience working with complex family systems and dynamics
- Experience working in Duals (DSNP) and/or Medicaid environment
- Knowledge of symptom identification and intervention, associated with Behavioral Health and Substance Use disorders
- Knowledge of APS reporting processes
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.
