Field Behavioral Health Case Manager - Pueblo and Colorado Springs, CO

Behavioral Health Case Manager

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.

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

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:

• Experience with electronic charting
• Experience with arranging community resources
• Field based work experience
• Experience working with complex family systems and dynamics
• Experience in Crisis Intervention
• Experience working in Duals (DSNP) and/or Medicaid environment
• Background in managing populations with complex medical or behavioral needs
• 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
• 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). 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.