you, UnitedHealth Group is strong on innovation. And like you, we'll go the
distance to deliver high-quality care. As part of our clinical support team,
you will be a key component in customer satisfaction and have a responsibility
to make every contact informative, productive and positive for our members and
providers. You'll have the opportunity to do live outreach, educating members
about program benefits and services while also helping to manage member cases.
Bring your skills and talents to a role where you'll have a chance to make an
*****This is afull time, Monday-Friday position. The Social Work Case Manager / CareCoordinator must be able to travel within Tucson metropolitan area or as neededin order to conduct critical face to face assessments. Territory Assignmentsare based on business needs. Applicants must be willing to carry a diverseclinical caseload and visit the member in their home and SNF*****
- Assess,plan and implement care strategies that are individualized by patient anddirected toward the most appropriate, lease restrictive level of care
- Utilizeboth company and community-based resources to establish a safe andeffective case management plan for members
- Collaboratewith patient, family, and healthcare providers to develop anindividualized plan of care
- Identifyand initiate referrals for social service programs; including financial,psychosocial, community, and state supportive services
- Managecare plan throughout the continuum of care as a single point of contact
- Communicatewith all stakeholders the required health-related information to ensurequality coordinated care and services are provided expeditiously to allmembers
- Advocatefor patients and families as needed to ensure the patients needs andchoices are fully represented and supported by the healthcare team
- Utilizeapproved clinical criteria to assess and determine appropriate level ofcare for members.
- Documentall member assessments, care plan and referrals provided
- Participatein interdisciplinary team meetings and Utilization Management rounds andprovide information to assist with safe transitions of care
- Understandinsurance products, benefits, coverage limitations, insurance andgovernmental regulations as it applies to the health plan
- Accountableto understand role and how it affects utilization management benchmarksand quality
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.
- Master's degree in Social Work (MSW)
- Licensed Social Worker State of Arizona
- Access to reliable transportation that will enable you to travel to client and/or member sites within a designated area which includes but not limited to Tucson metropolitan area ( up to 75% of the time in the field); there will be 10% travel to Phoenix for meetings and trainings
- Background in managing populations with complex medical or behavioral needs
- 2+ years of varied clinical experience with an emphasis on case management or utilization management
- Experience in a managed care organization
- Case Management experience
- Experience with electronic charting
- Experience with arranging community resources
- Field based work experience
OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Masters degree in Social Work , MSW, Social Worker, SNF, continuum of care, social services, social worker case manager, Tucson, AZ, Arizona, Telecommute, Remote