- Engages and manages high-risk enrollees, monitors utilization, creates care plans to address problems while maintaining quality of care
- Utilizes advanced clinical skills to make effective decisions to meet the enrollee’s health needs, using education, communication, and all available resources to promote quality, cost - effective outcomes
- Screens, identifies and obtains approval on high - risk / cost, catastrophic, long term chronic cases which will benefit from care management services. Referrals for such cases may originate from various departments within the company, not limited to the nurse team
- Integrates a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates the options and services to meet the enrollee’s health needs, using education, communication, and all available resources to promote quality, cost-effective outcomes
- Collaborates with regional care advocacy, provider network, and nurse team to ensure proper resource allocation and utilization to facilitate quality cost-effective patient outcome
- Collaborates with providers to determine acuity of mental health concerns and refer enrollees to appropriate community resources
- Licensed Master's degree in Psychology, Social Work, Counseling or Marriage or Family Counseling, or Licensed Ph.D.
- Licenses must be independent, active, and unrestricted
- 2+ years post - Masters experience in a related mental health environment
- Proficient computer skills and good working knowledge of Microsoft Word
- Medical/Behavioral setting experience (i.e. hospital, managed care organization, or joint medical/behavioral outpatient practice)
- Dual diagnosis experience with mental health and substance abuse
- Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients
- Able to function independently and responsibly with minimal supervision
- Maintain direct and open communication with all levels of the organization
- Able to handle sensitive issues with members and providers in a confidential manner
- Demonstrates initiative in achieving individual, team, and organizational goals and objectives
- Ability and flexibility to assume responsibilities and tasks in a constantly changing work environment
- Strong oral and written communication skills — specifically telephone skills
- Call center experience
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
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: Wellness, Recovery, Care Advocate, (WRCA) Eden Prairie, MN