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UnitedHealth Group Social Worker - Healthcare - Telecommute in IN or OH in Carmel, Indiana

OptumCare is a rapidly growing national, integrated health care organization that helps physicians and other providers deliver the right care at the right time in the right setting. We design and manage delivery systems in markets where we can achieve the Quadruple Aim — a better patient experience, higher quality care, lower costs, and a better experience for providers. With our expertise and resources, we are on the front lines transforming the health care delivery system to help improve the overall health of patients and communities.

This physician led, patient centric, and data driven business creates value by delivering and facilitating care across the full continuum through high performing networks comprised of owned, managed and contracted physicians, advanced practitioners and other providers. Our system impact extends across physicians, specialty care, urgent care, home health, post-acute transitions, complex care in skilled nursing facilities and palliative care.

Job Summary

The Social Worker is responsible for the assessment, planning, coordination and oversight of services for identified patients’ within their respective healthcare plan. The position identifies, evaluates, and provides management of services for patients with complex, catastrophic, SDoH (Social Determinants of Health) and/or psychosocial issues to promote quality, effective outcomes throughout the care continuum. The position ensures compliance with state and federal health plan requirements, Medicare guidelines and standards. Acts as a liaison to coordinate and collaborate care with physicians, family, and other providers while always remaining an advocate for patients, putting them at the center of care delivery. The Social Worker will interact and engage with others as an interdisciplinary team member.

If you are located in Indiana or Ohio, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Perform comprehensive evaluations and document findings in a concise/comprehensive manner that is compliant with documentation standards for the Center for Medicare and Medicaid Services (CMS)

  • Performs patient assessments in multiple settings to include but not limited to the patient’s home, the PCP/specialists clinic, hospital, and/or skilled nursing facility as needed

  • Understands and plans to assure services provided work within the boundaries of the patient’s plan eligibility

  • Coordinates identified patient’s needs utilizing federal, state, and local community resources, as available

  • Coordinates with external and internal teams to minimize obstacles and increase in patient and provider satisfaction

  • Active participation in Performance Improvement (PI) or regional strategic initiatives

  • Active participation in staff and Interdisciplinary Teams (IDT) meetings

  • Adheres to organizational and departmental policies and procedures

  • Maintains a high level of professionalism and adheres to the WellMed Core Values

  • Assumes responsibility for personal and professional development

  • Ensures licensure, certifications, and annual training are maintained and compliant

  • Attends required meetings and participates in adhoc committees as needed

  • Maintains knowledge of all health plan benefits, network, NCQA regulations, health plan policies

  • Identifies opportunities for process improvement in all aspects of patient care

  • Must maintain strict confidentiality at all times

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:

  • Bachelor of Social Work or equivalent work experience

  • 3+ years of social work experience in a health care environment/adult case management

  • Reside in Ohio or Indiana

  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

Preferred Qualifications:

  • Masters or Bachelor’s of Social Work with licensure (LMSW or LCSW or LBSW)

  • 1+ years of managed care and/or case management experience

  • Experience working with geriatric and behavioral and mental health patient populations

  • Long Term Care experience

  • Possess planning, organizing, conflict resolution, negotiating and interpersonal skills

  • Knowledgeable in Microsoft Office applications including Outlook, Word, and Excel

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

Job Keywords: Social worker, social work, healthcare, Medicare, Medicare Advantage, Medicaid, Optum, UnitedHealth Group, Ohio, Indiana, Carmel, IN, WFH, work from home, work at home, telecommute, telecommuter, telecommuting, remote