Telephonic Behavioral Health Case Manager, DSNP, Optum Care at Home - Remote in WA

About the job

Optum Care at Home, part of Optum Home & Community Care, is hiring a Telephonic Behavioral Health Case Manager for its Dual Special Needs Plan (DSNP) program. This Washington-based remote role supports members by phone in both Washington and Colorado, coordinating behavioral health, substance use, medical and community services for adults with complex needs.

The DSNP program uses an interdisciplinary model of care for adults whose needs span medical, behavioral health, substance use and social issues.

What you'll do

• Complete behavioral health assessments by phone
• Support people with substance use disorders, serious mental illness, chronic or co-occurring conditions and complex social needs
• Create and manage individual care plans for high-risk members
• Work with behavioral health providers to gather clinical information and plan and coordinate treatment
• Review treatment requests and clinical records to judge medical necessity, appropriate use, care quality and the right level of care
• Track treatment progress and talk with providers about ongoing needs
• Explain Medicaid and Medicare benefits to members and help them use covered services
• Link members to LTSS, HCBS and other community resources for health-related social needs
• Support members moving out of hospitals, skilled nursing, residential treatment and other settings
• Assess and respond to crises, coordinating with providers and community resources, and document all work electronically

What you need

• A master's degree in social work or a related behavioral health field
• Active Washington behavioral health licensure (for example LICSW, LCSW, LMSW or equivalent)
• Licensure in the assigned states, or the ability to get it by your start date
• 2+ years in a healthcare setting and 1+ years of clinical or case management experience
• Experience assessing behavioral health or substance use conditions
• Experience with Medicaid long term care, LTSS, home and community-based services or a similar Medicaid care management program
• A passed drug test before starting

Preferred

• Experience with DSNP, Medicare Advantage, Medicaid managed care or similar programs
• Care management experience in the field, in homes or in the community
• Experience with medically complex, high-risk or dual-eligible members
• Experience in crisis intervention, risk assessment, APS reporting or care transitions
• Experience linking members with social services and community resources

Schedule

• Remote role, by phone

Benefits

• A comprehensive benefits package
• Incentive and recognition programs
• Employee stock purchase
• A 401k contribution
• Development for other roles