Case Manager -LTSS - Mesa County, Colorado in surrounding areas

Optum; Grand Junction (CO); Remote; USD 40,000 - 72,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive programs

Stock purchase plan

401k contribution

Job summary

Optum in the United States seeks a Field-based LTSS Case Manager to support long-term services with home visits and in-facility care coordination. Travel up to 50% within assigned territory is required, with remote work flexibility for Colorado residents in Mesa County.

The role emphasizes confidentiality, regular reassessments, and collaborative care planning. You will conduct intake, assessments, and ongoing monitoring, ensuring timely documentation and adherence to CMA agreements.

Qualifications

• Bachelor’s degree in human behavioral sciences or related field.
• 5+ years of LTSS experience or a combination of education and experience.
• Proficiency with MS Office required.

Responsibilities

• Intake/screening/referral, assessment/reassessment, development of support plans, ongoing case management, and documentation.
• Maintain confidentiality of patient information per policy and law.
• Conduct monitoring contacts quarterly or as needed by LTSS rules.
• Face-to-face member contact at least every six months and update assessments accordingly.
• Complete annual face-to-face reassessments and additional assessments as required.
• Monitor service delivery within the Support Plan and PAR.
• Attend CMA training and in-service offerings.
• Work in accordance with CMA Contract requirements for accuracy and timeliness.
• Refer suspected mistreatment to protective services and law enforcement when needed.
• May take on special projects and assist with system assessments.
• Travel is required; independent transportation is needed; Colorado licensure and auto-insurance required if driving.

Skills

Strong communication

Travel readiness

Confidentiality

Detail oriented

Education

Bachelor's degree in human services|social work|psychology|public health

5+ years LTSS experience

Combo of education and experience

Tools

MS Office (Word, Excel, Outlook)

Job description

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

Positions in this function supports corporate objectives by utilizing a demonstrated competency of Long Term Services and Supports to provide Case Management. Participates in case conferences with the Supervisor.

Expect to spend about 50% of your time in assigned territory visiting our members in their homes or in long-term care facilities. You'll need to be flexible, adaptable and, above all, patient in all types of situations.

If you are located in Colorado and locally to Mesa County, CO, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Intake/screening/referral, assessment/reassessment, development of support plans, on-going case management, monitoring of the Member's health and welfare, documentation of contacts and case management activities in the Department-prescribed system, resource development, and case closure
• Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. Maintain confidentiality of patient information. The ability to maintain confidentiality is a critical and essential component of this position
• Conduct monitoring contacts as prescribed by the Department. Contact the Member at least once within each quarterly period or more frequently as warranted by the Member's condition/or as determined by the rules of the LTSS Program in which the Member is enrolled
• Conduct face-to-face contact with the Member's at least every six months or more frequently if warranted by the Member's condition or the rules of the LTSS Program in which the Member is enrolled. Update the current approved assessment tool and care or support plan in the appropriate documentation system(s) to reflect any changes in condition or services
• Complete a new assessment during a face-to-face reassessment annually or more frequently if warranted by the Member's condition or if required by the rules of the LTSS Program in which the Member is enrolled. Complete additional assessments as needed/required
• Monitor the delivery of services and supports identified within the Support Plan and the Prior Authorization Request (PAR)
• Attend Department provided training for CMA agencies as well as agency provided in-service and staff development training
• Responsible to conduct Work that is in accordance with the CMA Contract Agreement's requirements. This includes but is not limited to, providing Work that is accurate, timely, and complete
• In the event, at any time throughout the case management process, the case manager suspects an individual to be a victim of mistreatment, abuse, neglect, exploitation or a harmful act, the case manager shall immediately refer the individual to the protective services section of the county department of social services of the individual's county of residence and/or the local law enforcement agency
• May take on special assignments and projects on an as needed basis. Assist with system assessment and development as needed
• This position requires travel. Requires independent, reliable, flexible, and on-demand, transportation at the incumbent's expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage

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:

• Must meet one of the following:
  • Bachelor's degree in one of the human behavioral science fields such as human services, social work, psychology, or public health
  • 5+ years of relevant experience in the field of LTSS
  • Combination of education and experience
• 1+ years of experience with MS Office, including Word, Excel, and Outlook
• Access to reliable transportation and the ability to travel up to 50% within assigned territory to meet with members and providers
• Reside locally to Mesa County, CO
• Driver's License and access to reliable transportation

Preferred Qualification:

• Experience as a caseworker or case manager with LTSS population, in a private or public social services agency may substitute for the required education on a year for year basis

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29.00 to $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.