Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs – helping patients access and navigate care anytime and anywhere.

　　As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home.

　　We’re connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.

　　The Optum Dual Special Needs Plan / Optum at Home program is a longitudinal, integrated care delivery program that coordinates the delivery and provision of clinical care for members in their place of residence. The program provides telephonic and in-home services, care, and interventions to members through annual comprehensive assessments, ongoing visits for higher risk members, care coordination during transitions from the hospital or nursing home, and continued care management. Trained clinicians provide intensive interventions customized to the needs of each member in conjunction with the Interdisciplinary Care Team comprised of the Optum clinician, the member’s Primary Care Provider, and other providers / professionals.

　　The overall goals of the Optum at Home program are multi-faceted including:

　　Improved cost savings through reduced:

　　Medical expense

　　Acute admissions

　　Acute Readmissions

　　ER Visits

　　Accurate coding of all acute and chronic diagnoses including supporting individualized plans of care

　　Appropriate preventative care and closure of appropriate Star gaps

　　A holistic approach to members as a single point of contact helps navigate complex chronic health challenges and / or socioeconomic needs, drawing on the Interdisciplinary Care Team to support members’ unique needs

　　As a Behavioral Health Advocate, you will be responsible for the case management / care coordination of behavioral health and substance abuse cases through review and evaluation of inpatient and outpatient behavioral health treatments for medical necessity, emergency status, and quality of care. You'll have a direct impact on the lives of our members as you recommend and manage the appropriate level of care throughout the entire treatment plan.

　　This is a telephonic, work-from-home position that may include up to 25% in-home visits in the Washington, DC area based on business needs.

　　If you live in the Washington, DC area, you’ll enjoy the flexibility to work remotely* as you take on some tough challenges.

　　Primary Responsibilities:

　　Make patient assessments and determine appropriate levels of behavioral health care

　　Obtain information from providers on outpatient requests for treatment

　　Determine if additional clinical treatment sessions are needed

　　Manage behavioral health cases throughout the entire treatment plan

　　Administer benefits and review treatment plans

　　Coordinate benefits and transitions between various areas of care

　　Communicate with members who have complex behavioral health needs and possible communication barriers

　　Identify ways to add value to treatment plans and consult with facility staff or outpatient care providers on those ideas

　　Focus on whole person care for psychiatric and chemical dependency members

　　Build relationships and work with a variety of populations within the local community

　　Work with low-income populations with complex social and medical needs including adults with serious mental illness and emotional disturbances, members with substance use disorders, and members with other complex or multiple chronic conditions

　　Collaborate with medical directors on medical expense initiatives

　　You’ll be rewarded and 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.

　　Required Qualifications:

　　Licensed Master's degree in Psychology, Social Work, Counseling, or Marriage and Family Counseling; Licensed Ph.D., or Registered Nurse with 2+ years of experience in behavioral health

　　Active, unrestricted, license to practice independently (without supervision) in Washington, DC

　　2+ years of post-license experience in a related mental health environment

　　Intermediate Microsoft skills including Word, Excel, Outlook, and Team

　　Access to secure, high-speed internet (Broadband Cable, DSL, or Fiber) and a dedicated, distraction-free workspace at home

　　Access to reliable transportation that will allow you to conduct in-home visits in the DC area based on business needs

　　Reside in the Washington, DC area

　　Preferred Qualifications:

　　2+ years of hands-on experience with HEDIS, Stars, quality initiatives

　　Experience working in Duals (DSNP) and/or Medicaid environment

　　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

　　Proven solid demonstrated written and verbal communication and relationship building skills

　　Proven solid demonstrated planning and organizational skills

　　Proven ability to work independently as well as a member of a team

　　*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

　　At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

　　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.