Quality Manager

3 weeks ago

Sacramento, United States Allen Spolden Full time

Job DescriptionPrimary Responsibilities:Make patient assessments in home setting and determining appropriate levels of behavioral care neededObtain information from providers on outpatient requests for treatmentDetermine if additional clinical treatment sessions are neededManage behavioral health cases throughout the entire treatment planAdminister benefits and review treatment plans in collaboration with interdisciplinary care teamAssist in coordinating Medicaid/Medicare benefits and transitions between various areas of careCommunicate with members who have complex medical needs and may have communication barriersIdentify ways to add value to treatment plans and consulting with facility staff or outpatient care providers on those ideasFocus on whole person care model for psychiatric and chemical dependency patientsBuild relationships and work with a variety of populations within the communityAbility to work with low - income populations with complex social and medical needs including adults with serious mental illness and emotional disturbances, members with substance use disorders, and members with other complex or multiple chronic conditionsYou'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.RequirementsRequired Qualifications:Master's degree in Social Work1+ years of clinical or case management experience2+ years of experience in long-term care, home health, hospice, public health or assisted livingExperience working with MS Word, Excel and OutlookFull COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodationPreferred Qualifications:LCSW licenseProven background in managing populations with complex medical or behavioral needsExperience with electronic chartingExperience with arranging community resourcesField based work experienceDemonstrated knowledge of both medical and behavioral health diagnosis and terminologyProven knowledge of symptom identification and intervention, associated with behavioral health and substance use disordersProven knowledge of APS reporting processesExperience working with complex family systems and dynamicsProven knowledge of resources to address SDOHExperience in crisis interventionProven understanding of health disparities among various membership, based on their race or ethnicity; religion; socioeconomic status; sexual orientation; gender, gender identity; age; mental health; cognitive, sensory or physical disability; geographic location or other characteristics historically linked to discrimination and exclusionExperience working in Duals (DSNP) and/or Medicaid environmentAbility to work independently as well as a member of a teamExcellent written and verbal communication and relationship building skillsPlanning and organizational skillsProficient with Microsoft Word, Excel, Outlook, PowerPointBenefitsDental, Medical, Vision and 401K

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