Case Manager jobs at UnitedHealth Group

The Optum family of businesses, is seeking a Behavioral Health Case Manager to join our team in Missouri. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone. The Behavioral Health Case Manager will provide telephonic and in-person support for both direct referrals and data identified referrals. This requires clinical expertise and the ability to negotiate the complexities involved with special needs conditions such as substance use, suicidality/homicide, major depression, ADHD, eating disorders, and severe mental illness. This position may require minimal field work to meet with members at local facilities in the future. **Primary Responsibilities:** + Facilitate member education and involvement of caregiver in the delivery of interventions + Provide advocacy and support to member and family members, including caregiver support & appropriate referral to applicable / needed resources + Ensure that members understand treatment options and are effectively linked to treatment resources + Promote health, wellness and optimal psychosocial functioning for member (identify caregiver gaps, facilitate education and respite support) + Consider the member's needs holistically to identify gaps in care requiring intervention + Exhibit excellent customer service in engaging providers in collaborative planning + Create and maintain appropriate clinical records + Participate as directed in clinical rounds with other members of the team and other external health care management organizations / vendors, as applicable. Also participate in advancing the Quality Improvement Program + Conduct condition specific research to meet member needs + Maintain success stories which can be utilized to promote program + Provide case management support for individuals who meet diagnostic requirements including engagement of member and/ or family making available support throughout the entire continuum of treatment + Explanation of authorization process + Complete discharge follow-up & if needed, discharge planning / support 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:** + Master's degree in Psychology, Social Work, Counseling, or Marriage and Family Counseling or Licensed Ph.D. + Active, unrestricted clinical license to practice independently without supervision in the state of Missouri + 2+ years of post-licensure experience in a related mental health environment + 1+ years of case management experience + Proven intermediate level computer skills including proficiency with MS Office Suite + Access to high-speed internet (Broadband Cable, DSL, Fiber) and a dedicated workspace at home + Reside in Missouri **Preferred Qualifications:** + Hospital experience including intakes, assessments, discharge planning, and/or case management + Community mental health experience including case management + Experience doing chart reviews + Experience consulting with facility and/or hospital staff to coordinate treatment plans + 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 + Experience with government funded programs **Explore opportunities at Optum Behavioral Care.** We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while **Caring. Connecting. Growing together.** Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _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._ _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Become a part of our caring community and help us put health first Join Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care management to frail elders and adults with intellectual, developmental, or physical disabilities who qualify for Wisconsin's FC program. Bring your compassion and expertise to help members access vital resources, promote independence, and enhance their quality of life within their communities. Key responsibilities: Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP). Coordinate services that address members' health and safety needs, ensuring support is provided in the least restrictive environment in accordance with the MCP. Collaborate continuously with a Field Care Nurse (RN) to review and update care plans and address members' evolving needs. Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member's residence. Schedule, conduct, and document quarterly in-person visits and maintain monthly contact with members by phone. Identify, arrange, and monitor support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs. Engage in clear and empathetic communication with members to better understand their needs, support informed decision-making, and ensure cost-effective service delivery. Prioritize safety by continuously evaluating risk factors and providing education to members to promote overall health and wellness. Maintain accurate and timely documentation of activities, including case notes, service authorizations, and updates to the Member Care Plan. Foster direct collaboration with service providers, natural supports, and other community partners to enhance member outcomes. Travel is necessary to conduct member visits and fulfill role responsibilities. Use your skills to make an impact Required Qualifications Four-year bachelor's degree in human services or related field with one (1) year of experience working with at least one of the Family Care target populations OR a four-year bachelor's degree in any other field with three (3) years' related experience working with at least one of the Family Care target populations. Demonstrated intermediate computer proficiency, including experience with Microsoft Office applications. ***The Family Care target group population is defined as: frail elders and adults with intellectual, developmental, or physical disabilities*** Preferred Qualifications Case Management experience Experience with electronic case note documentation and experience with documenting in multiple computer applications/systems Knowledge of community health and social service agencies and additional community resources Additional Information Workstyle: This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes. Work Location: Eau Claire and surrounding areas Travel: up to 40% throughout Eau Claire and surrounding areas. Mileage reimbursement follows our mileage policy. Typical Workdays/Hours: Monday - Friday, 8:00 am - 4:30 pm CST Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $53,700 - $72,600 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. Excellent benefits package, including 401k, tuition, licensure and certification reimbursement. We promote healthy & wellness lifestyles and offer specialty programs here at Aetna. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard. Job Description JOIN OUR GROWING TEAM Are you tired of bedside nursing? Are you looking to get away from 12-hour hospital shifts while continuing to utilize your RN expertise to impact the lives of patients in your local community? We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Registered Nurses to join our Workers' Compensation Field Case Management team. This opportunity offers a competitive salary, full benefits, and a performance-based bonus paid out on a monthly or quarterly basis. POSITION SUMMARY Responsible for assessing and analyzing an injured employee to evaluate the medical and vocational needs required to facilitate the patients appropriate and timely return to work. Acts as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel. Fundamental Components but not limited to the following: Assesses and analyzes an injured employees medical and vocational status; develops a plan of care to facilitate the patients appropriate and timely return to work. Interviews patients in their homes, work-sites, or physicians office to provide ongoing case management services. Monitors patient progress toward desired outcomes through assessment and evaluation. Communicates both in-person and telephonically with patient, medical providers, attorneys, employers and insurance carriers; prepares all required documentation of case work activities. May arrange referrals, consultations and therapeutic services for patients; confers with specialists concerning course of care and treatment. Develops and administers educational and prevention programs. Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources. Testifies as required to substantiate any relevant case work or reports. Daily travel in the field. Qualifications BACKGROUND/EXPERIENCE: Registered Nurse (RN) with active state license in good standing in the state where job duties are performed required Minimum 2 years clinical nursing background required Bilingual Spanish Speaking Fluent preferred Prior case management and workers' compensation experience preferred Ability to multitask in a fast paced work environment Strong computer skills with experience in Microsoft Office Products Excellent communication skills EDUCATION The minimum level of education desired for candidates in this position is a Associate's degree or equivalent experience. LICENSES AND CERTIFICATIONS Nursing/Registered Nurse (RN) is required Nursing/Certified Case Manager (CCM) is desired Telework Specifications: Full time WAH with daily travel in the field. Candidates should reside in the San Fernando Valley/Los Angeles area. Additional Information We offer you: Autonomy Productivity incentive Home every night, weekend and holiday! Schedule Monday-Friday All major holidays are paid time off, vacation and sick time off is accrued. Full benefits offered including 401(k) and many corporate discounts available. Employees are reimbursed for fees to maintain licensure as well as free CEU's to maintain licensure. Continuing Education credits are available/provided for RN and a various industry certifications too. Work from home with in-state travel. In addition to annual salary, position has potential for a monthly monetary bonus. Mileage reimbursement is provided per the IRS rate. Coventry provides laptop, IPhone, fax/scanner/printer, as well as office supplies. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. All employees are expected to embody our values of Excellence, Integrity, Caring and Inspiration in all that they do as an employee. The overall responsibility of the Field Case Manager is to ensure the injured worker receives the best possible care in a timely and efficient manner towards full rehabilitation and return to work. Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

The Optum family of businesses, is seeking a Behavioral Health Case Manager to join our team in Missouri. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone. The Behavioral Health Case Manager will provide telephonic and in-person support for both direct referrals and data identified referrals. This requires clinical expertise and the ability to negotiate the complexities involved with special needs conditions such as substance use, suicidality/homicide, major depression, ADHD, eating disorders, and severe mental illness. This position may require minimal field work to meet with members at local facilities in the future. Primary Responsibilities: * Facilitate member education and involvement of caregiver in the delivery of interventions * Provide advocacy and support to member and family members, including caregiver support & appropriate referral to applicable / needed resources * Ensure that members understand treatment options and are effectively linked to treatment resources * Promote health, wellness and optimal psychosocial functioning for member (identify caregiver gaps, facilitate education and respite support) * Consider the member's needs holistically to identify gaps in care requiring intervention * Exhibit excellent customer service in engaging providers in collaborative planning * Create and maintain appropriate clinical records * Participate as directed in clinical rounds with other members of the team and other external health care management organizations / vendors, as applicable. Also participate in advancing the Quality Improvement Program * Conduct condition specific research to meet member needs * Maintain success stories which can be utilized to promote program * Provide case management support for individuals who meet diagnostic requirements including engagement of member and/ or family making available support throughout the entire continuum of treatment * Explanation of authorization process * Complete discharge follow-up & if needed, discharge planning / support 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: * Master's degree in Psychology, Social Work, Counseling, or Marriage and Family Counseling or Licensed Ph.D. * Active, unrestricted clinical license to practice independently without supervision in the state of Missouri * 2+ years of post-licensure experience in a related mental health environment * 1+ years of case management experience * Proven intermediate level computer skills including proficiency with MS Office Suite * Access to high-speed internet (Broadband Cable, DSL, Fiber) and a dedicated workspace at home * Reside in Missouri Preferred Qualifications: * Hospital experience including intakes, assessments, discharge planning, and/or case management * Community mental health experience including case management * Experience doing chart reviews * Experience consulting with facility and/or hospital staff to coordinate treatment plans * 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 * Experience with government funded programs Explore opportunities at Optum Behavioral Care. We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while Caring. Connecting. Growing together. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. 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. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This role supports a 24 hour/365 day crisis call center. Applicants must reside in Louisiana. Position Purpose: Work in collaboration with schools of higher education, county first responders, law enforcement, emergency departments, providers, crisis mobile teams and the Cenpatico Crisis Line provider to support the delivery of coordinated and effective crisis services. Develop relationship with all local schools of higher education and coordinate crisis prevention and disaster recovery efforts Verify crisis provider services are delivered in accordance to contract expectations Facilitate the issuing of Corrective Action letters to providers for non-compliance to contract requirements Verify follow-up occurs after crisis interventions to effectively coordinate care Educate local schools of higher education about how to identify the early warning signs of mental illness and what actions to take to safeguard students, faculty and the community Support the Crisis System Plan and the development of provider crisis programs and services within the Provider Network. Monitor the performance of the Crisis Line provider, Crisis Mobile Teams and other providers of crisis services Support the development of Crisis Response Center processes to verify effective coordination of care with other providers Establish baseline data; collect, analyze and report outcomes and progress in reaching program goals. Support the coordination of crisis system processes among system partners, including schools of higher education, crisis providers, intake agencies, emergency rooms, police and fire Conduct root causes analyses, conduct rapid cycle improvement processes Conduct cross departmental and cross system collaborative meetings to execute initiatives and resolve system issues Receive and respond to external system partner related issues in a timely manner Troubleshoot service delivery and coordination issues on behalf of system partners Educate system partners regarding policies and procedures related to referrals, website education, and problem solving Implement and monitor project plans to meet goals and timelines Request corrective action plans from providers that are non-compliant and/or fail to meet contract requirements Develop training modules and train appropriate users Support the involvement of Peer and Family Support Services, and wrap around and community based services to both stabilize and reduce crisis in the community. Provide on-call telephonic coverage 24 hours a day, in rotation as assigned, to provide consultation Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's degree in Behavioral Health or equivalent experience. 5+ years of related experience. Master's degree in Behavioral Health or Social Science preferred. License/Certificates: Licensed Independent Substance Abuse Counselor (LISAC), Licensed Master Social Worker (LMSW), Licensed Bachelor Social Worker (LBSW), Certified Employee Assistance Professional (CEAP) or Licensed Marriage & Family Therapist (LMFT) preferred. For LA Healthcare Connections plan only: One of the following licenses is required: Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), or Licensed Addiction Counselor (LAC) Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

The Optum family of businesses, is seeking a Behavioral Health Case Manager to join our team in Missouri. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone. The Behavioral Health Case Manager will provide telephonic and in-person support for both direct referrals and data identified referrals. This requires clinical expertise and the ability to negotiate the complexities involved with special needs conditions such as substance use, suicidality/homicide, major depression, ADHD, eating disorders, and severe mental illness. This position may require minimal field work to meet with members at local facilities in the future. **Primary Responsibilities:** + Facilitate member education and involvement of caregiver in the delivery of interventions + Provide advocacy and support to member and family members, including caregiver support & appropriate referral to applicable / needed resources + Ensure that members understand treatment options and are effectively linked to treatment resources + Promote health, wellness and optimal psychosocial functioning for member (identify caregiver gaps, facilitate education and respite support) + Consider the member's needs holistically to identify gaps in care requiring intervention + Exhibit excellent customer service in engaging providers in collaborative planning + Create and maintain appropriate clinical records + Participate as directed in clinical rounds with other members of the team and other external health care management organizations / vendors, as applicable. Also participate in advancing the Quality Improvement Program + Conduct condition specific research to meet member needs + Maintain success stories which can be utilized to promote program + Provide case management support for individuals who meet diagnostic requirements including engagement of member and/ or family making available support throughout the entire continuum of treatment + Explanation of authorization process + Complete discharge follow-up & if needed, discharge planning / support 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:** + Master's degree in Psychology, Social Work, Counseling, or Marriage and Family Counseling or Licensed Ph.D. + Active, unrestricted clinical license to practice independently without supervision in the state of Missouri + 2+ years of post-licensure experience in a related mental health environment + 1+ years of case management experience + Proven intermediate level computer skills including proficiency with MS Office Suite + Access to high-speed internet (Broadband Cable, DSL, Fiber) and a dedicated workspace at home + Reside in Missouri **Preferred Qualifications:** + Hospital experience including intakes, assessments, discharge planning, and/or case management + Community mental health experience including case management + Experience doing chart reviews + Experience consulting with facility and/or hospital staff to coordinate treatment plans + 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 + Experience with government funded programs **Explore opportunities at Optum Behavioral Care.** We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while **Caring. Connecting. Growing together.** Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _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._ _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

The Optum family of businesses, is seeking a Behavioral Health Case Manager to join our team in Missouri. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone. The Behavioral Health Case Manager will provide telephonic and in-person support for both direct referrals and data identified referrals. This requires clinical expertise and the ability to negotiate the complexities involved with special needs conditions such as substance use, suicidality/homicide, major depression, ADHD, eating disorders, and severe mental illness. This position may require minimal field work to meet with members at local facilities in the future. **Primary Responsibilities:** + Facilitate member education and involvement of caregiver in the delivery of interventions + Provide advocacy and support to member and family members, including caregiver support & appropriate referral to applicable / needed resources + Ensure that members understand treatment options and are effectively linked to treatment resources + Promote health, wellness and optimal psychosocial functioning for member (identify caregiver gaps, facilitate education and respite support) + Consider the member's needs holistically to identify gaps in care requiring intervention + Exhibit excellent customer service in engaging providers in collaborative planning + Create and maintain appropriate clinical records + Participate as directed in clinical rounds with other members of the team and other external health care management organizations / vendors, as applicable. Also participate in advancing the Quality Improvement Program + Conduct condition specific research to meet member needs + Maintain success stories which can be utilized to promote program + Provide case management support for individuals who meet diagnostic requirements including engagement of member and/ or family making available support throughout the entire continuum of treatment + Explanation of authorization process + Complete discharge follow-up & if needed, discharge planning / support 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:** + Master's degree in Psychology, Social Work, Counseling, or Marriage and Family Counseling or Licensed Ph.D. + Active, unrestricted clinical license to practice independently without supervision in the state of Missouri + 2+ years of post-licensure experience in a related mental health environment + 1+ years of case management experience + Proven intermediate level computer skills including proficiency with MS Office Suite + Access to high-speed internet (Broadband Cable, DSL, Fiber) and a dedicated workspace at home + Reside in Missouri **Preferred Qualifications:** + Hospital experience including intakes, assessments, discharge planning, and/or case management + Community mental health experience including case management + Experience doing chart reviews + Experience consulting with facility and/or hospital staff to coordinate treatment plans + 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 + Experience with government funded programs **Explore opportunities at Optum Behavioral Care.** We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while **Caring. Connecting. Growing together.** Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _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._ _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

The Optum family of businesses, is seeking a Behavioral Health Case Manager to join our team in Missouri. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone. The Behavioral Health Case Manager will provide telephonic and in-person support for both direct referrals and data identified referrals. This requires clinical expertise and the ability to negotiate the complexities involved with special needs conditions such as substance use, suicidality/homicide, major depression, ADHD, eating disorders, and severe mental illness. This position may require minimal field work to meet with members at local facilities in the future. **Primary Responsibilities:** + Facilitate member education and involvement of caregiver in the delivery of interventions + Provide advocacy and support to member and family members, including caregiver support & appropriate referral to applicable / needed resources + Ensure that members understand treatment options and are effectively linked to treatment resources + Promote health, wellness and optimal psychosocial functioning for member (identify caregiver gaps, facilitate education and respite support) + Consider the member's needs holistically to identify gaps in care requiring intervention + Exhibit excellent customer service in engaging providers in collaborative planning + Create and maintain appropriate clinical records + Participate as directed in clinical rounds with other members of the team and other external health care management organizations / vendors, as applicable. Also participate in advancing the Quality Improvement Program + Conduct condition specific research to meet member needs + Maintain success stories which can be utilized to promote program + Provide case management support for individuals who meet diagnostic requirements including engagement of member and/ or family making available support throughout the entire continuum of treatment + Explanation of authorization process + Complete discharge follow-up & if needed, discharge planning / support 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:** + Master's degree in Psychology, Social Work, Counseling, or Marriage and Family Counseling or Licensed Ph.D. + Active, unrestricted clinical license to practice independently without supervision in the state of Missouri + 2+ years of post-licensure experience in a related mental health environment + 1+ years of case management experience + Proven intermediate level computer skills including proficiency with MS Office Suite + Access to high-speed internet (Broadband Cable, DSL, Fiber) and a dedicated workspace at home + Reside in Missouri **Preferred Qualifications:** + Hospital experience including intakes, assessments, discharge planning, and/or case management + Community mental health experience including case management + Experience doing chart reviews + Experience consulting with facility and/or hospital staff to coordinate treatment plans + 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 + Experience with government funded programs **Explore opportunities at Optum Behavioral Care.** We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while **Caring. Connecting. Growing together.** Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _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._ _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together As a Field-Based Case Manager (CM), you will act in a liaison role to ensure appropriate care is accessed, as well as to provide home and social assessments and member education. Case Managers work in a team based structure and spend the majority of their time in the community engaging directly with members. If you reside within a commutable distance of Pickaway, Fairfield, Ross, Fayette or Madison Counties, OH, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: * Engage members either face to face or over the phone to assist with closing gaps in care, linking to necessary services and providing education about their health * Review available member service records and relevant documentation (e.g. utilization history, functional level, stratification information, current plan of care) * Conduct member health assessment that includes bio-psychosocial, functional, and behavioral health needs * Utilize interviewing techniques and active listening to collect and retain member information and incorporating responses as they are presented to complete assessment * Identify member service needs related to health concerns * Identify urgent member situations * Engage member to participation in the assessment process and collaboratively develop Care Plan based on individual needs, preferences, and objectives * Provide nursing oversight while collaborating with Care Guides (CGs) * Work with members to develop healthcare goals and identify potential barriers to achieving healthcare goals * Identify member support systems available and incorporate into their Care Plan * Review plan benefits and identify appropriate programs and services based on health needs and benefits * Integrate health care and services needs into a plan or recommendation for member care and service * Work collaboratively with the interdisciplinary care team to ensure an integrated tam approach * Collaborate with member to create solutions to overcome barriers to achieving healthcare goals * Identify relevant community resources available based on member needs * Refer members to appropriate programs and services * Facilitate member choice of preferred provider * Advocate for individuals and communities within the health and social service systems 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: * State of Ohio RN License, and applicable degree * Field-based experience * Knowledge of culture and values of community * Familiarity with the resources available in the community * Resided within the local community for 2+ years * Reside or be able to commute within Jefferson County, Ohio * Ability to travel locally up to 75% of the time * Access to reliable transportation that will enable you to travel to member and/or patient sites within a designated area * Available to work Monday through Friday 8:00 AM to 5:00 PM * Have a dedicated work area established that is separated from other living areas and provides information privacy * Proven ability to keep all company sensitive documents secure * Live in a location that can receive UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Preferred Qualifications: * Case Management Certification (CCM) * Care management experience * Experience working in Managed Care * Telephonic customer service experience * Knowledge of Medicaid and/or Medicare population * Knowledge and/or experience with behavioral health or substance use disorders * Employment in a medical office or other provider environment * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. #UHCPJ 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together** As a Field-Based Case Manager (CM), you will act in a liaison role to ensure appropriate care is accessed, as well as to provide home and social assessments and member education. Case Managers work in a team based structure and spend the majority of their time in the community engaging directly with members. **If you reside within a commutable distance of Pickaway, Fairfield, Ross, Fayette or Madison Counties, OH, you will have the flexibility to work remotely* as you take on some tough challenges.** **Primary Responsibilities:** + Engage members either face to face or over the phone to assist with closing gaps in care, linking to necessary services and providing education about their health + Review available member service records and relevant documentation (e.g. utilization history, functional level, stratification information, current plan of care) + Conduct member health assessment that includes bio-psychosocial, functional, and behavioral health needs + Utilize interviewing techniques and active listening to collect and retain member information and incorporating responses as they are presented to complete assessment + Identify member service needs related to health concerns + Identify urgent member situations + Engage member to participation in the assessment process and collaboratively develop Care Plan based on individual needs, preferences, and objectives + Provide nursing oversight while collaborating with Care Guides (CGs) + Work with members to develop healthcare goals and identify potential barriers to achieving healthcare goals + Identify member support systems available and incorporate into their Care Plan + Review plan benefits and identify appropriate programs and services based on health needs and benefits + Integrate health care and services needs into a plan or recommendation for member care and service + Work collaboratively with the interdisciplinary care team to ensure an integrated tam approach + Collaborate with member to create solutions to overcome barriers to achieving healthcare goals + Identify relevant community resources available based on member needs + Refer members to appropriate programs and services + Facilitate member choice of preferred provider + Advocate for individuals and communities within the health and social service systems 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:** + State of Ohio RN License, and applicable degree + Field-based experience + Knowledge of culture and values of community + Familiarity with the resources available in the community + Resided within the local community for 2+ years + Reside or be able to commute within Jefferson County, Ohio + Ability to travel locally up to 75% of the time + Access to reliable transportation that will enable you to travel to member and/or patient sites within a designated area + Available to work Monday through Friday 8:00 AM to 5:00 PM + Have a dedicated work area established that is separated from other living areas and provides information privacy + Proven ability to keep all company sensitive documents secure + Live in a location that can receive UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service **Preferred Qualifications:** + Case Management Certification (CCM) + Care management experience + Experience working in Managed Care + Telephonic customer service experience + Knowledge of Medicaid and/or Medicare population + Knowledge and/or experience with behavioral health or substance use disorders + Employment in a medical office or other provider environment *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. \#UHCPJ _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.** **UnitedHealthcare Community & State Senior Care Options plan** is a Fully Integrated Dual-Special Needs Plan (FIDE-SNP) serving dually eligible individuals in the Commonwealth of Massachusetts aged 65 or greater. This position reports to the Health Services Director in the Health Services Department within the Senior Care Options Plan. This position sets team direction, resolves problems and provides direction to nurse case managers. This position adapts departmental plans and priorities to address business and operational challenges such as staffing, the clinical model and inter-departmental actions and goals. 10% of expected travel within Massachusetts. If you reside near Worcester, MA, you will enjoy the flexibility to telecommute* as you take on some tough challenges." **Primary Responsibilities:** **Leadership:** + Supervises a team that varies in size based upon Capacity Plans and staffing models. Direct reports are located at same site, at home or at a remote UHC site + Hires, manages and develops new employees and proactively monitors individual and team performance by providing frequent, ongoing feedback and coaching + Implement strategies to improve operational performance, quality and delivery service to constituents + Leads regular team meetings to communicate changes, relevant operational performance information and/or to build employee engagement + Utilizes Our United Culture concepts and tools and delivers on the commitments + Demonstrates a positive leadership shadow by shaping positive behaviors in areas of influence, building integrity, influencing our values and creating a healthy, high-performance environment **Drive Effective Clinical Decisions within a Business Environment:** **Operational Performance:** + Develops and/or implements bottoms-up strategies to improve operational performance + Continually stays abreast of operational performance, identifies degradation in service levels and leads to remediation of issues + Responsible for the interview and selection decisions on new hire staffing within their own hierarchy + Accountable for a successful new hire onboarding experience + Responsible for creating a positive and meaningful onboarding experience for all employees + Delivers and documents one-on-one coaching to improve all aspects of performance and effectiveness + Completes "side-by-side" monitoring/coaching with direct reports on a regular basis + As needed, prepares, delivers and manages remediation plans + Participate in job fairs, open houses and other recruitment events as needed + Ensure compliance with Model of Care and State contractual requirements (Chart audits) + Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business results + Use appropriate business metrics (e.g. member/FTE, length of stay, readmission rates, STAR ratings, member engagement rates) and applicable processes/tools (e.g. cost benefit analysis, return on investment, performance, staffing calculator) to optimize decisions and clinical outcomes + Prioritize work based on business algorithms and established work processes, or in their absence, identify business priorities and build consensus to triage and deliver work (e.g. assessments, case/claim loads, previous hospitalizations, acuity, morbidity rates, quality of care follow up) + Understand and operate effectively/efficiently within legal/regulatory requirements (e.g., HIPAA, CMS, State) **Coaching & Performance Management:** + Communicate with direct reports on a regular basis through coaching sessions and by providing timely, actionable feedback + Ensures performance metrics and goals are reviewed on a regular and frequent basis, with time set aside for incidental issues + Provides purposeful and actionable development feedback to direct reports and monitors to support their performance improvement + If, after the action items of the development plan do not yield the desired positive results in the agreed upon timeframe, CAP is initiated in accordance with UHG policies and practices + Works with HRdirect on disciplinary actions or terminations and seeks manager approval on all terminations + Tracks and manages attendance and punctuality in a timely and accurate manner **Development & Employee Engagement:** + Prepares and delivers thorough and meaningful performance discussions and documents with data and fact-based examples to reduce ambiguity of ongoing expectations + Creates purposeful and actionable development plans, reviews with employees and monitors to support their performance improvement expectations and development + Engages in regular, meaningful and candid development and career discussions with direct reports + Guides employees to leverage available training and development resources + Analyzes and understands Employee experience survey results and communicates results to team members + Works to establish an action plan to address opportunity areas and improve results + Supports overall organization in employee engagement programs and communications **Communication:** + Holds consistent 1:1meetings with direct reports + Regularly leverages various communication channels, including one-on-ones and new hire class leadership interactions to foster two-way communication. Inspires employees to see the link between their position and personal performance to organizational strategy, company performance and the UHC brand **Demonstrate Business and Industry Knowledge:** + Demonstrate knowledge of computer functionality and software applications (e.g., navigating systems, troubleshooting, electronic charting, accessing intranet and record management databases) + Demonstrate knowledge of relevant state and federal guidelines (e.g., Medicare, Medicaid,) or regulatory bodies (e.g., EOHHS, HIPAA, Milliman) + Demonstrate understanding of relevant health care benefit plans + Demonstrate knowledge of applicable area of clinical specialization + Utilize resources to enhance professional practice and development based on learning gaps or new information You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Unrestricted Nursing license in the state of MA + 5+ years of care management experience and/or 5+ years of equivalent clinical knowledge and experience such as social care, healthcare coordination, quality improvement + 1+ years of experience with SharePoint and shared network drives + Intermediate level of proficiency with Microsoft Office applications, including Word, Excel and PowerPoint + Access to reliable transportation and valid US driver's license **Preferred Qualifications:** + BS / BA Degree + 3+ years of leadership experience + Proven ability to focus activities on a strategic direction and achieve targets + Time management and prioritization skills + Strong written and verbal professional communication skills + Excellent team development skills + Strong interpersonal skills + Ability to work in a self-directed manner in a fast-paced, rapidly changing environment + Demonstrated leadership abilities *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable. _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO #GREEN

Explore opportunities with VNA of Maryland, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** As the Transitional Case Manager (TCM), you will be facilitating seamless transitions for patients from facility settings to post-acute care. You will verify home health orders, assess care requirements, and ensure continuity of care. Your role includes assessing patients' health literacy, involving patients and families in care planning, and providing education to improve outcomes and promote self-management. You will implement rehospitalization reduction initiatives for patients at risk and communicate with healthcare providers throughout the transition. You'll enjoy the flexibility to work remotely as you take on some tough challenges. **Primary Responsibilities:** + Educate patients on post-discharge follow-up, homebound criteria, and obtaining prescriptions + Assess readmission risk using the LACE tool + Ensure patients and families have agency contact information + Coordinate ancillary services (DME, Infusion) as needed + Assist in preparing for patient care post-discharge + Liaise between the agency and healthcare providers + Communicate patient transfers and coordinate resumption of care + Provide feedback on readmissions and non-admit decisions + Perform other duties as assigned 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:** + Current, unrestricted RN, LPN, or SW licensure in state of practice + Current CPR certification + 1+ years home health experience or 1+ years of hospital case management experience + Current driver's license, vehicle insurance, access to a dependable vehicle or public transportation *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $48,700 to $87,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. **\#LHCJobs** _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. UnitedHealthcare Community & State Senior Care Options plan is a Fully Integrated Dual-Special Needs Plan (FIDE-SNP) serving dually eligible individuals in the Commonwealth of Massachusetts aged 65 or greater. This position reports to the Health Services Director in the Health Services Department within the Senior Care Options Plan. This position sets team direction, resolves problems and provides direction to nurse case managers. This position adapts departmental plans and priorities to address business and operational challenges such as staffing, the clinical model and inter-departmental actions and goals. 10% of expected travel within Massachusetts. If you reside near Worcester, MA, you will enjoy the flexibility to telecommute* as you take on some tough challenges." Primary Responsibilities: Leadership: * Supervises a team that varies in size based upon Capacity Plans and staffing models. Direct reports are located at same site, at home or at a remote UHC site * Hires, manages and develops new employees and proactively monitors individual and team performance by providing frequent, ongoing feedback and coaching * Implement strategies to improve operational performance, quality and delivery service to constituents * Leads regular team meetings to communicate changes, relevant operational performance information and/or to build employee engagement * Utilizes Our United Culture concepts and tools and delivers on the commitments * Demonstrates a positive leadership shadow by shaping positive behaviors in areas of influence, building integrity, influencing our values and creating a healthy, high-performance environment Drive Effective Clinical Decisions within a Business Environment: Operational Performance: * Develops and/or implements bottoms-up strategies to improve operational performance * Continually stays abreast of operational performance, identifies degradation in service levels and leads to remediation of issues * Responsible for the interview and selection decisions on new hire staffing within their own hierarchy * Accountable for a successful new hire onboarding experience * Responsible for creating a positive and meaningful onboarding experience for all employees * Delivers and documents one-on-one coaching to improve all aspects of performance and effectiveness * Completes "side-by-side" monitoring/coaching with direct reports on a regular basis * As needed, prepares, delivers and manages remediation plans * Participate in job fairs, open houses and other recruitment events as needed * Ensure compliance with Model of Care and State contractual requirements (Chart audits) * Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business results * Use appropriate business metrics (e.g. member/FTE, length of stay, readmission rates, STAR ratings, member engagement rates) and applicable processes/tools (e.g. cost benefit analysis, return on investment, performance, staffing calculator) to optimize decisions and clinical outcomes * Prioritize work based on business algorithms and established work processes, or in their absence, identify business priorities and build consensus to triage and deliver work (e.g. assessments, case/claim loads, previous hospitalizations, acuity, morbidity rates, quality of care follow up) * Understand and operate effectively/efficiently within legal/regulatory requirements (e.g., HIPAA, CMS, State) Coaching & Performance Management: * Communicate with direct reports on a regular basis through coaching sessions and by providing timely, actionable feedback * Ensures performance metrics and goals are reviewed on a regular and frequent basis, with time set aside for incidental issues * Provides purposeful and actionable development feedback to direct reports and monitors to support their performance improvement * If, after the action items of the development plan do not yield the desired positive results in the agreed upon timeframe, CAP is initiated in accordance with UHG policies and practices * Works with HRdirect on disciplinary actions or terminations and seeks manager approval on all terminations * Tracks and manages attendance and punctuality in a timely and accurate manner Development & Employee Engagement: * Prepares and delivers thorough and meaningful performance discussions and documents with data and fact-based examples to reduce ambiguity of ongoing expectations * Creates purposeful and actionable development plans, reviews with employees and monitors to support their performance improvement expectations and development * Engages in regular, meaningful and candid development and career discussions with direct reports * Guides employees to leverage available training and development resources * Analyzes and understands Employee experience survey results and communicates results to team members * Works to establish an action plan to address opportunity areas and improve results * Supports overall organization in employee engagement programs and communications Communication: * Holds consistent 1:1meetings with direct reports * Regularly leverages various communication channels, including one-on-ones and new hire class leadership interactions to foster two-way communication. Inspires employees to see the link between their position and personal performance to organizational strategy, company performance and the UHC brand Demonstrate Business and Industry Knowledge: * Demonstrate knowledge of computer functionality and software applications (e.g., navigating systems, troubleshooting, electronic charting, accessing intranet and record management databases) * Demonstrate knowledge of relevant state and federal guidelines (e.g., Medicare, Medicaid,) or regulatory bodies (e.g., EOHHS, HIPAA, Milliman) * Demonstrate understanding of relevant health care benefit plans * Demonstrate knowledge of applicable area of clinical specialization * Utilize resources to enhance professional practice and development based on learning gaps or new information You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Unrestricted Nursing license in the state of MA * 5+ years of care management experience and/or 5+ years of equivalent clinical knowledge and experience such as social care, healthcare coordination, quality improvement * 1+ years of experience with SharePoint and shared network drives * Intermediate level of proficiency with Microsoft Office applications, including Word, Excel and PowerPoint * Access to reliable transportation and valid US driver's license Preferred Qualifications: * BS / BA Degree * 3+ years of leadership experience * Proven ability to focus activities on a strategic direction and achieve targets * Time management and prioritization skills * Strong written and verbal professional communication skills * Excellent team development skills * Strong interpersonal skills * Ability to work in a self-directed manner in a fast-paced, rapidly changing environment * Demonstrated leadership abilities * All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.** **UnitedHealthcare Community & State Senior Care Options plan** is a Fully Integrated Dual-Special Needs Plan (FIDE-SNP) serving dually eligible individuals in the Commonwealth of Massachusetts aged 65 or greater. This position reports to the Health Services Director in the Health Services Department within the Senior Care Options Plan. This position sets team direction, resolves problems and provides direction to nurse case managers. This position adapts departmental plans and priorities to address business and operational challenges such as staffing, the clinical model and inter-departmental actions and goals. 10% of expected travel within Massachusetts. If you reside near Worcester, MA, you will enjoy the flexibility to telecommute* as you take on some tough challenges." **Primary Responsibilities:** **Leadership:** + Supervises a team that varies in size based upon Capacity Plans and staffing models. Direct reports are located at same site, at home or at a remote UHC site + Hires, manages and develops new employees and proactively monitors individual and team performance by providing frequent, ongoing feedback and coaching + Implement strategies to improve operational performance, quality and delivery service to constituents + Leads regular team meetings to communicate changes, relevant operational performance information and/or to build employee engagement + Utilizes Our United Culture concepts and tools and delivers on the commitments + Demonstrates a positive leadership shadow by shaping positive behaviors in areas of influence, building integrity, influencing our values and creating a healthy, high-performance environment **Drive Effective Clinical Decisions within a Business Environment:** **Operational Performance:** + Develops and/or implements bottoms-up strategies to improve operational performance + Continually stays abreast of operational performance, identifies degradation in service levels and leads to remediation of issues + Responsible for the interview and selection decisions on new hire staffing within their own hierarchy + Accountable for a successful new hire onboarding experience + Responsible for creating a positive and meaningful onboarding experience for all employees + Delivers and documents one-on-one coaching to improve all aspects of performance and effectiveness + Completes "side-by-side" monitoring/coaching with direct reports on a regular basis + As needed, prepares, delivers and manages remediation plans + Participate in job fairs, open houses and other recruitment events as needed + Ensure compliance with Model of Care and State contractual requirements (Chart audits) + Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business results + Use appropriate business metrics (e.g. member/FTE, length of stay, readmission rates, STAR ratings, member engagement rates) and applicable processes/tools (e.g. cost benefit analysis, return on investment, performance, staffing calculator) to optimize decisions and clinical outcomes + Prioritize work based on business algorithms and established work processes, or in their absence, identify business priorities and build consensus to triage and deliver work (e.g. assessments, case/claim loads, previous hospitalizations, acuity, morbidity rates, quality of care follow up) + Understand and operate effectively/efficiently within legal/regulatory requirements (e.g., HIPAA, CMS, State) **Coaching & Performance Management:** + Communicate with direct reports on a regular basis through coaching sessions and by providing timely, actionable feedback + Ensures performance metrics and goals are reviewed on a regular and frequent basis, with time set aside for incidental issues + Provides purposeful and actionable development feedback to direct reports and monitors to support their performance improvement + If, after the action items of the development plan do not yield the desired positive results in the agreed upon timeframe, CAP is initiated in accordance with UHG policies and practices + Works with HRdirect on disciplinary actions or terminations and seeks manager approval on all terminations + Tracks and manages attendance and punctuality in a timely and accurate manner **Development & Employee Engagement:** + Prepares and delivers thorough and meaningful performance discussions and documents with data and fact-based examples to reduce ambiguity of ongoing expectations + Creates purposeful and actionable development plans, reviews with employees and monitors to support their performance improvement expectations and development + Engages in regular, meaningful and candid development and career discussions with direct reports + Guides employees to leverage available training and development resources + Analyzes and understands Employee experience survey results and communicates results to team members + Works to establish an action plan to address opportunity areas and improve results + Supports overall organization in employee engagement programs and communications **Communication:** + Holds consistent 1:1meetings with direct reports + Regularly leverages various communication channels, including one-on-ones and new hire class leadership interactions to foster two-way communication. Inspires employees to see the link between their position and personal performance to organizational strategy, company performance and the UHC brand **Demonstrate Business and Industry Knowledge:** + Demonstrate knowledge of computer functionality and software applications (e.g., navigating systems, troubleshooting, electronic charting, accessing intranet and record management databases) + Demonstrate knowledge of relevant state and federal guidelines (e.g., Medicare, Medicaid,) or regulatory bodies (e.g., EOHHS, HIPAA, Milliman) + Demonstrate understanding of relevant health care benefit plans + Demonstrate knowledge of applicable area of clinical specialization + Utilize resources to enhance professional practice and development based on learning gaps or new information You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Unrestricted Nursing license in the state of MA + 5+ years of care management experience and/or 5+ years of equivalent clinical knowledge and experience such as social care, healthcare coordination, quality improvement + 1+ years of experience with SharePoint and shared network drives + Intermediate level of proficiency with Microsoft Office applications, including Word, Excel and PowerPoint + Access to reliable transportation and valid US driver's license **Preferred Qualifications:** + BS / BA Degree + 3+ years of leadership experience + Proven ability to focus activities on a strategic direction and achieve targets + Time management and prioritization skills + Strong written and verbal professional communication skills + Excellent team development skills + Strong interpersonal skills + Ability to work in a self-directed manner in a fast-paced, rapidly changing environment + Demonstrated leadership abilities *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable. _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO #GREEN

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.** We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today! The **Telephonic Case Manager RN Medical/Oncology** will identify, coordinate, and provide appropriate levels of care. The Telephonic Case Manager RN Medical/Oncology is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. **This is a full-time, Monday - Friday, 8am-5pm position in your time zone.** You'll enjoy the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Make outbound calls and receive inbound calls to assess members current health status + Identify gaps or barriers in treatment plans + Provide patient education to assist with self-management + Make referrals to outside sources + Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction + Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes. 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:** + Current, unrestricted RN license in state of residence + Active Compact RN License or ability to obtain upon hire + 3+ years of experience in a hospital, acute care or direct care setting + Proven ability to type and have the ability to navigate a Windows based environment + Have access to high-speed internet (DSL or Cable) + Dedicated work area established that is separated from other living areas and provides information privacy **Preferred Qualifications** + BSN + Certified Case Manager (CCM) + 1+ years of experience within Medical/Oncology + Case management experience + Experience or exposure to discharge planning + Experience in a telephonic role + Background in managed care *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._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.** We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today! The **Telephonic Case Manager RN Medical/Oncology** will identify, coordinate, and provide appropriate levels of care. The Telephonic Case Manager RN Medical/Oncology is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. **This is a full-time, Monday - Friday, 8am-5pm position in your time zone.** You'll enjoy the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Make outbound calls and receive inbound calls to assess members current health status + Identify gaps or barriers in treatment plans + Provide patient education to assist with self-management + Make referrals to outside sources + Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction + Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes. 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:** + Current, unrestricted RN license in state of residence + Active Compact RN License or ability to obtain upon hire + 3+ years of experience in a hospital, acute care or direct care setting + Proven ability to type and have the ability to navigate a Windows based environment + Have access to high-speed internet (DSL or Cable) + Dedicated work area established that is separated from other living areas and provides information privacy **Preferred Qualifications** + BSN + Certified Case Manager (CCM) + 1+ years of experience within Medical/Oncology + Case management experience + Experience or exposure to discharge planning + Experience in a telephonic role + Background in managed care *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._

A great opportunity to help military members and their families! This position is responsible for providing confidential behavioral health consultations and 1-12 fifty minute sessions of non-medical counseling (EAP) to members of the military and their family. Non-medical counseling is focused on a specific issue or concern and includes developing strategies and solutions, building on the participant's strengths, accessing support systems, and utilizing community resources. Sessions are provided telephonically, via video or secure chat and are intended to be solution focused and short-term. Non-medical Counseling topics are varied but often include the following issues: Stress Transition/Relocation Grief and loss Employment issues Marital/couple conflict or communication Parent-Child Relational Problems Academic or Educational problems Problems related to Primary Support The successful candidate will have demonstrated excellence with solution focused therapy with a passion to deliver a service experience that exceeds the participant's expectation. The team works in a fast-paced environment, on a queue, taking non-medical counseling calls in the moment, as well as through scheduled appointments. The team is staffed 24/7 in support of the schedules of miliary members around the world. This role offers a great salary with an excellent benefits package that starts your first day of employment including a continuing education program with funding and extra leave time. Duties and Responsibilities: Provide participants with confidential, non-medical counseling services Assess the participant's immediate risk and biopsychosocial needs Provide appropriate referrals for resources and treatment Use clinical expertise, professional judgment and best practices Execute duty to warn/mandated reporting processes Partner with peers and leaders promoting and embracing a culture of change; supporting all parties through the change process Demonstrate the ability to be agile and flexible in work process. Deliver excellent clinical judgment and interpersonal communication skills Understand confidentiality and privacy regulations Demonstrate excellent verbal and written communication Display knowledge and understanding of the military lifestyle and culture while maintaining the highest degree of sensitivity, compassion and respect for Service Members and their families. Qualifications: Must be a U.S. Citizen Master's degree or PhD from an accredited graduate program in a mental health related field such as social work, psychology, marriage/family therapy, or counseling Current, valid, unrestricted counseling license in Texas that grants the authority to provide counseling services as an independent practitioner in their respective fields. Multi-state licensure highly preferred. Ability to meet the expectation to sit / apply for cross-licensure in additional state(s). Licensure costs will be fully covered by the company upon hire Minimum 4 years post masters clinical experience as a mental health and/or substance use clinician with demonstrated understanding of multiple therapeutic modalities, including brief therapy. Knowledge and experience with Employee Assistance Programs (CEAP certification optional) Knowledge and experience in crisis management Solid understanding of Z-codes Proficient with multiple software and system applications. Demonstrated ability to set priorities including, but not limited to time management and organizational skills Ability to manage own caseload and coordinate all assigned cases Passion for helping the military community Understanding of military life and culture After accepting an offer of employment, obtain and maintain a federal public trust clearance status with the US Government. The information that will be requested during the process can be reviewed on the U.S. General Services Administration website: SF85P QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS. You do not need to complete this form or provide any information until after you have accepted an offer of employment. If you are provided an offer of employment and accept, you will need to provide the requested information on the public trust questionnaire directly to the government through a third-party collection agency. Since public trust clearance is a condition of employment, this means that if you are unable to obtain clearance or if you lose clearance, you will not be eligible to work in this position, and your offer may be rescinded or employment may be terminated. REQUIRED WORK HOURS: Full time job with a minimum of forty hours per week five days a week. Shift days and times may vary due to business need. All staff schedules include rotating shifts, weekends and holiday time. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 65,600 - 109,400 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. *M-F 8-5 EST/CST* *Partnerships In Care Program* Position Purpose: Performs reviews of member's care and health status of Applied Behavioral Analysis (ABA) services provided to determine medical appropriateness. Monitors clinical effectiveness and efficiency of member's care in accordance with ABA guidelines. Evaluates member's care and health status before, during, and after provision of Applied Behavioral Analysis (ABA) services to ensure level of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder needs and clinical standards Performs prior authorization reviews related to BH to determine medical appropriateness in accordance with ABA regulatory guidelines and criteria Analyzes BH member data to improve quality and appropriate utilization of services Interacts with BH healthcare providers as appropriate to discuss level of care and/or services provided to members receiving Applied Behavior Analysis Services Provides education to members and their families regrading ABA and BH utilization process Provides feedback to leadership on opportunities to improve care services through process improvement and the development of new processes and/or policies Performs other duties as assigned. Complies with all policies and standards. *M-F 8-5 EST/CST* *Partnerships In Care Program* Education/Experience: Requires Graduate of an Accredited School of Nursing or Bachelor's degree and 2-4 years of related experience. For Enterprise Population Health 2+ years providing ABA services as a BCBA License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state (BCBA) required. Master's degree for behavioral health clinicians required. Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare teams to review care services related to Applied Behavior Analysis Services preferred. License/Certification: LCSW- License Clinical Social Worker required or LMHC-Licensed Mental Health Counselor required or LPC-Licensed Professional Counselor required or Licensed Marital and Family Therapist (LMFT) required or Licensed Mental Health Professional (LMHP) required or Board Certified Behavior Analyst (BCBA) required RN - Registered Nurse - State Licensure and/or Compact State Licensure RN - Registered Nurse- State Licensure and/or Compact State Licensure with BCBA required or Independent licensure with ABA experience and BCBA preferred. preferred Licensed Behavior Analyst (LBA) where required by state required Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Our mission is to provide immediate, personalized clinical support-whether it's a moment of crisis, clinical consultation, or a step towards lasting change. Our mission is to be responsive, collaborative, and impactful with each connection. As a Behavioral Licensed Clinician on our 24/7 Clinical Support Team, you will deliver expert, compassionate care across a wide spectrum of behavioral health needs. This team is designed to ensure continuity-each Behavioral Licensed Clinician remains with the customer throughout their journey, becoming a trusted clinical partner. While every team member supports various clinical populations and needs, we value and will leverage subject matter expertise in the development of training, curriculum, and clinical consultation. You'll be called on to bring depth into your areas of specialization while remaining flexible and responsive across all cases. The successful candidate will have demonstrated clinical excellence with mental health, substance use disorders, crisis call work, and case management with a passion to deliver a service experience that exceeds the member's or provider's expectation. The team works in a fast-paced environment, on a queue, taking telephonic calls in the moment, balanced with scheduled calendar appointments. The team operates 24/7/365 in support of the full organization. Duties and Responsibilities Serve as a consistent clinical point of contact for each member from first engagement through every stage of their wellness journey Assess members' immediate risk and clinical needs using evidence-based models and clinical acumen Provide real-time crisis de-escalation, safety planning, and risk management Identify biopsychosocial needs and collaborate with the member to determine solutions and next steps Develop SMART goals that empower members to lead and maintain a healthy lifestyle Assesses readiness to change and implements actions to assist members in moving through stages of change to reach their goals Sheppard members to appropriate clinical care, treatment programs, and community resources Incorporate a variety of modalities to educate members about benefit plans, coverage, and care navigation Leveraging an evidence-based specialized curriculum in a wide range of clinical areas that support our members' unique needs Perform research and provide relevant educational or support resources tailored to the member's situation Partner with internal colleagues to ensure timely follow-up, case collaboration, and seamless care transitions Demonstrate agility in balancing real-time queue work with out-of-queue case management responsibilities Exhibit diplomacy, empathy, and professionalism-even in difficult conversations or with resistant participants Comply with HIPAA and uphold strict confidentiality and compliance standards while demonstrating sound clinical documentation practices Able to manage multiple health records and systems to accurately document customer interactions and progress Communicate effectively and succinctly in both verbal and written format Perform other related duties incidental to the work described herein Qualifications Master's degree or PhD in a mental health field (e.g., Social Work, Counseling, Psychology) or RN with psychiatric specialization. Current independent clinical license (e.g., LCSW, LPC, LMFT, LPCC, PhD, PsyD, PMHNP, or RN with psychiatric focus) Minimum 5 years of post-licensure experience as a behavioral health or substance use clinician Bilingual in Spanish preferred Demonstrated use of evidence-based approaches, including brief therapy, cognitive-behavioral therapy, and motivational interviewing Experience working in or with managed care environments preferred Experience with direct member communication (written and verbal), experience in telephonic counseling/coaching preferred Required to obtain AAS Crisis Specialist Certification within the first year of employment EAP (Employee Assistance Program) experience and CEAP certification preferred but not required Strong clinical acumen, interpersonal communication skills, and comfort working in a dynamic and rapid pace environment Proven administrative abilities, with strong computer and software application skills REQUIRED WORK HOURS: Full-time job with a minimum of forty hours per week. Shift days and times may vary due to business need. All staff schedules include rotating shifts, weekends, and holiday time. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 65,600 - 109,400 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.