United Health Group
United Health Group
In your field, learning never stops. And neither do you. You are continually pushing yourself to reach higher and go further. To do everything you can to ensure a positive outcome for our patients. Staying on top of your game and persevering in the face of challenge will be a big part of your success. And at every turn, you'll have the support of an elite and dynamic team. Join us in this role and you will use your diverse knowledge and experience to make health care work better for our patients, while doing your life's best work.(sm)
Schedule: Monday - Friday 8am - 5pm
Assess, plan, document and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care
Utilize both company and community-based resources to establish a safe and effective case management plan for members
Collaborate with patient, family, and healthcare providers to develop an individualized plan of care and participate in interdisciplinary team meetings and UM rounds
Identify and initiate referrals for social service programs; including financial, psychosocial, community, and state supportive services
Manage care plan throughout the continuum of care as a single point of contact
Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the healthcare team
Utilize approved clinical criteria to assess and determine appropriate level of care for members
Understand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health plan
Completes home visits when needed
Bachelor degree in Social work or MSW
3 years of clinical or case management experience
3 years of experience in long-term care, home health, hospice, public health or assisted living
Medicare / Medicaid experience
Experience working with commercial insurances
Experience in behavioral health
Experience with electronic charting
Basic level of Microsoft office (Word, Excel, Internet, Outlook)
North American Medical Management, California, Inc.
(NAMM California) partnered with OptumHealth in 2012. NAMM California and OptumHealth share a common goal of bringing patients, physicians, hospitals and payers closer together in the mission to increase the quality, efficiency and affordability of care. NAMM California is a part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. NAMM California develops and manages provider networks, offering a full range of services to assist physicians and other providers in supporting patient care coordination and their managed care business operations. For over 18 years, NAMM California has been an innovator in health care with a track record for quality, financial stability, extraordinary services and integrated medical management programs. NAMM California is well positioned to continually invest in its infrastructure and systems for the benefit of its provider clients and to accommodate the impending changes that will come forth from healthcare reform.
The NAMM California provider clients represent a network of almost 600 primary care physicians and over 3,000 specialists and work with the premier hospitals in their respective markets
The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis (Internal Candidates) are not eligible to receive a sign on bonus.
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: LCSW, MSW, Medicaid, Medicare, Managed care, health plan, case management, Home health, hospice, SNF, commercial insurance, Ontario, San Bernardino, Chino, Riverside, CA
United Health Group