Behavioral Health Inpatient Utilization Management - RN - LCSW - Phoenix, AZ

There’s an energy and excitement here, a shared mission to improve the lives of others as well as our own. A passion for excellence you won’t find anywhere else. We ask tough questions. We push ourselves and each other to find smarter solutions. The result is a culture of performance that’s driving the health care industry forward. Nursing here isn’t for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Learn more, and start doing your life’s best work.(sm)
 
What makes your clinical career greater with UnitedHealth Group? You’ll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
As an office based Behavioral Health Inpatient Utilization Manager, you will drive positive outcomes by supporting a diverse member population ensuring the right care is provided at the right time and place.
***This position is located at CityScape, 1 East Washington Street, Phoenix, AZ. There is a potential opportunity to eventually work from home 2-3 days per week.***
Primary Responsibilities:


Use clinical skills to determine appropriate Inpatient Behavioral Health admissions

Identify gaps or barriers in treatment plans

Interact with Medical Directors and Inpatient Clinical Teams

Coordinate outpatient services for members being discharged from an Acute Behavioral Health Facility

Make referrals to outside sources

Coordinate physical services as needs are identified (home health, DME, etc.)

Document clinical reviews which supports the inpatient services

Utilize Milliman Care Guidelines (MCG) criteria to determine patients are in the correct hospital setting

Works with less structured, more complex issues

Serves as a resource to others

Assesses and interprets customer needs and requirements

Identifies solutions to non-standard requests and problems

Solves moderately complex problems and/or conducts moderately complex analyses

Works with minimal guidance; seeks guidance on only the most complex tasks

Translates concepts into practice

Provides explanations and information to others on difficult issues

Coaches, provides feedback and guides others
 

Required Qualifications: 


Current, unrestricted RN license or LCSW in the State of Arizona

2+ years of Behavioral Health experience

2+ years Utilization Management doing medical review utilizing Milliman guidelines, concurrent review, and discharge planning

Ability to prepare and document case summary’s 

Experience with special needs population

Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment
Preferred Qualifications:


Experience / exposure with discharge planning

Strong organizational skills and multitasking abilities will be keys to success

Strong communication skills with the ability to work with multiple levels of leadership
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)
 
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.
 
Job Keywords: Behavioral Health, BH, LCSW, License Clinical Social Worker, Inpatient, RN, Registered Nurse, Nurse, Utilization Management, UM, medical review, Milliman, concurrent review, discharge planning, special needs, children, Phoenix, AZ, Arizona