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in Fairfield, CA
TRICARE Behavioral Community Case Manager - Telecommuter, CA
Hours | Full-time, Part-time |
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Location | Fairfield, CA Fairfield, California |
About this job
Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Our UnitedHealthcare Military & Veterans organization has been selected to provide quality health care services for those who serve our nation. This is an opportunity to share in something special; an opportunity for all of us to serve those families who have made our nation stronger. It's an inspiring role and it can inspire your career. Find out more about these opportunities to do your life's best work.(SM)
We have an excellent opportunity available to join our company as a Behavioral Health Community Case Manager (CCM) in California. As a CCM, you will be responsible for working with a multidisciplinary team providing clinical case management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating.
This position provides both in-home, hospital based and telephonic case management and education in support of TRICARE beneficiaries. Our mission is to help people live their lives to the fullest. We live our values are Integrity, Compassion, Relationships, Innovation, and Performance.
Responsibilities:
- Educating and supporting the individual through home visits, face-to-face and telephonic assessment and expert clinical management interventions
- Evaluating delays in care, coordinates with Utilization Management team facilitating discharge planning, and arranging for alternative care services to facilitate timely and appropriate discharge
- Documenting all clinical information in accordance with UnitedHealthcare Military & Veterans policies and procedures in the member's electronic medical record.
- Assess and interprets beneficiary needs, gaps, and requirements related to his/her disease condition
- Develops CM care plan in collaboration with beneficiary/caregiver/provider in order to promote optimal health
- Collaborates with specialists, physicians, and medical directors to provide the necessary care and cost efficient care for the beneficiary related to their condition
- Assesses the effectiveness and quality of services provided related to clinical, functional, and outcomes
- Consulting and collaborating with Medical Surgical CM colleagues on Bio/Psycho/Social assessments and service plans within an integrated, multidisciplinary team.
- Adheres to all ethical, legal/regulatory and accreditation standards
Requirements
- Current, unrestricted RN license in your state of California; or Licensed as a Clinical Social Worker at the highest level in CA or Licensed at the highest level in another recognized mental health discipline (LMFT, etc.) is required
- At least 5 years of experience in a hospital setting, acute care, outpatient direct care experience OR experience as a telephonic Case Manager managing disease conditions
- A minimum of 3 years of case management experience
- A minimum of 3 years of Behavioral experience
- United States Citizenship
- Ability to obtain favorable adjudication following submission of Department of Defense form SF86 NAC form SF86
- Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment
- Excellent written and verbal communication skills
- Teamwork skills
- Detail oriented and highly organized
- Coaching skills
Additional Preferred Assets:
- Previous Face-to-Face Case Management or equivalent experience is preferred
- Experience in both medical and behavioral settings preferred
- Case Management Certification (CCM) Preferred or may obtain within 18 months.
- Prior telephonic Case or Disease Management experience
- Prior experience within a large managed care organization preferred
- Strong organizational skills and ability to multi-task
- Prior military case management program experience
- Prior military service or family military service
- Prior experience in start-up environments
- Master's Degree in a Mental Health discipline is Highly preferred