TRICARE Behavioral Health Community Case Manager - Honolulu, HI
UnitedHealth Group - Honolulu, HI

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Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Our UnitedHealthcare Military & Veterans organization has been selected to provide quality health care services for those who serve our nation. This is an opportunity to share in something special; an opportunity for all of us to serve those families who have made our nation stronger. It's an inspiring role and it can inspire your career. Find out more about these opportunities to do your life's best work.(SM)

UnitedHealthcare Military and Veteran have an excellent opportunity available to join our company as a Behavioral Health Community Case Manager (CCM) in Honolulu, Hawaii. As a CCM, you will be responsible for working with a multidisciplinary team providing clinical case management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating. This position provides both in-home, hospital based and telephonic case management and education in support of TRICARE beneficiaries. Our mission is to help people live their lives to the fullest. We live our values are Integrity, Compassion, Relationships, Innovation, and Performance.

***This is a field position;Target travel is a 40 mile radius in Honolulu, HI area; Work at home position with ideally 4 days in the field making visits with 1 home office day.***

Primary responsibilities:
  • Educating and supporting the individual through home visits, face-to-face and telephonic assessment and expert clinical management interventions
  • Evaluating delays in care, coordinates with Utilization Management team facilitating discharge planning, and arranging for alternative care services to facilitate timely and appropriate discharge
  • Documenting all clinical information in accordance with UnitedHealthcare Military & Veterans policies and procedures in the member's electronic medical record.
  • Assess and interprets beneficiary needs, gaps, and requirements related to his/her disease condition
  • Develops CM care plan in collaboration with beneficiary/caregiver/provider in order to promote optimal health
  • Collaborates with specialists, physicians, and medical directors to provide the necessary care and cost efficient care for the beneficiary related to their condition
  • Assesses the effectiveness and quality of services provided related to clinical, functional, and outcomes
  • Consulting and collaborating with Medical Surgical CM colleagues on Bio/Psycho/Social assessments and service plans within an integrated, multidisciplinary team.
  • Adheres to all ethical, legal/regulatory and accreditation standard
  • Current, unrestricted RN license in your state of HI; or Licensed as a Clinical Social Worker at the highest level in HI or Licensed at the highest level in another recognized mental health discipline (LMFT, etc.) is required
  • Master’s Degree in a Mental Health discipline is Highly preferred
  • Case Management Certification (CCM) Preferred or may obtain within 18 months.
  • Experience in both medical and behavioral settings preferred
  • At least 5 years of experience in a hospital setting, acute care, outpatient direct care experience OR experience as a telephonic Case Manager managing disease conditions
  • A minimum of 3 years of case management experience
  • United States Citizenship
  • Ability to obtain favorable adjudication following submission of Department of Defense form SF86 NAC form SF86
  • Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment
  • Excellent written and verbal communication skills
  • Teamwork skills
  • Detail oriented and highly organized
  • Coaching skills
Additional Preferred Assets:
  • Previous Face-to-Face Case Management or equivalent experience is preferred
  • Prior telephonic Case or Disease Management experience
  • Prior experience within a large managed care organization preferred
  • Strong organizational skills and ability to multi-task
  • Prior military case management program experience
  • Prior military service or family military service
  • Prior experience in start-up environments

As a requirement of UnitedHealth Group’s contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 http://www.opm.gov/forms/pdf_fill/sf86.pdf, (the National Agency Check or “NAC”). Successful completion of the NAC process is a requirement for continued employment in this role. NAC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense. Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received. Failure to obtain final NAC approval will result in termination from this role.

Careers at UnitedHealthcare Military & Veterans. When it comes to their health care, the men and women who help keep the peace deserve the greatest peace of mind. That’s why UnitedHealthcare is the organization that’s called on to serve them and their loved ones. We’re all about finding better ways to help improve their lives no matter where life may take them. So our career opportunities take challenge to a higher level. If you have a commitment to quality that mirrors our commitment to the men and women of the armed forces, take time to learn more about the career paths available here. It’s a genuine opportunity to do your life’s best work.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Keywords: Hawaii, Honolulu, HI, Nurse, clinical, RN, "Registered nurse", LCSW, Social Worker, LMFT, "home health", PsyD, Psychologist, "Case Management",CCM, public health,hospice, CM

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