UnitedHealthcare Military and Veterans is currently seeking a Behavioral Health Case (CM). As a Case Manager, 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 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.
Educating and supporting the individual through 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 in a multidisciplinary team.
Adheres to all ethical, legal/regulatory and accreditation standards
Current, unrestricted RN license in your state of residence; or Licensed as a Clinical Social Worker at the highest level in your state is required
Masterâ€™s Degree Required
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
T eamwork skills
Detail oriented and highly organized
Additional Preferred Assets:
Prior telephonic Disease Management experience
Case Management Certification (CCM) Preferred or may obtain within 18 months
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 Groupâ€™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 â€œNACâ€). 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. Thatâ€™s why UnitedHealthcare is the organization thatâ€™s called on to serve them and their loved ones. Weâ€™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. Itâ€™s a genuine opportunity to do your lifeâ€™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.
UnitedHealth Group - 20 months ago
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