Quality Manager

Primary Responsibilities:

• Make patient assessments in home setting and determining appropriate levels of behavioral care needed
  
• 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 in collaboration with interdisciplinary care team
  
• Assist in coordinating Medicaid/Medicare benefits and transitions between various areas of care
  
• Communicate with members who have complex medical needs and may have communication barriers
  
• Identify ways to add value to treatment plans and consulting with facility staff or outpatient care providers on those ideas
  
• Focus on whole person care model for psychiatric and chemical dependency patients
  
• Build relationships and work with a variety of populations within the community
  
• Ability to 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
  

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.

Requirements

Required Qualifications:

• Master’s degree in Social Work
  
• 1 years of clinical or case management experience
  
• 2 years of experience in long-term care, home health, hospice, public health or assisted living
  
• Experience working with MS Word, Excel and Outlook
  
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
  

Preferred Qualifications:

• LCSW license
  
• Proven background in managing populations with complex medical or behavioral needs
  
• Experience with electronic charting
  
• Experience with arranging community resources
  
• Field based work experience
  
• Demonstrated knowledge of both medical and behavioral health diagnosis and terminology
  
• Proven knowledge of symptom identification and intervention, associated with behavioral health and substance use disorders
  
• Proven knowledge of APS reporting processes
  
• Experience working with complex family systems and dynamics
  
• Proven knowledge of resources to address SDOH
  
• Experience in crisis intervention
  
• Proven understanding of health disparities among various membership, based on their race or ethnicity; religion; socioeconomic status; sexual orientation; gender, gender identity; age; mental health; cognitive, sensory or physical disability; geographic location or other characteristics historically linked to discrimination and exclusion
  
• Experience working in Duals (DSNP) and/or Medicaid environment
  
• Ability to work independently as well as a member of a team
  
• Excellent written and verbal communication and relationship building skills
  
• Planning and organizational skills
  
• Proficient with Microsoft Word, Excel, Outlook, PowerPoint
  

Benefits