Social Worker - Lcsw - Remote In Albuquerque Metro Area

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)

This role co-manages members with case and disease managers to assess, plan, facilitate and monitor options and services required to meet an individual’s healthcare needs, while promoting quality, and cost effective outcomes for members with complex psychosocial needs. Serves as liaison to teammates, Providers and patients as needed. Responsible for providing clinical social work services to members and families on an outpatient basis including, crisis intervention, short-term case management, and providing information and referrals to community resources. This is performed under the direct supervision of the Medical Director, Care Management. Adheres to policies, procedures and regulations to ensure compliance and patient safety. Participation in Compliance and other important training is a condition of employment.

If you are located in Albuquerque Metro Are, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Maintains current information on all frequently used community resources, financial resources and placement facilities
• Assists Care Managers with care coordination and discharge planning for patients with complex discharge needs
• Acts as a resource to department teammates, organization teammates, and Providers for difficult to manage members
• Performs psychosocial evaluations of member’s physical, social and emotional functioning as well as financial and family support as needed
• Routinely updates resource list and is available to discuss how to resource required services
• Uses, protects, and discloses The Medical Group patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Conducts telephonic, clinic, facility, hospital or home visits as indicated for patient evaluation/engagement
• Maintains statistical data on social work treatment plan, intervention and outcomes
• Provides community resource information to case and disease managers, providers, or directly to members or families
• Acts as a consultant to members requiring information on Advanced Directives or Power of Attorney
• Identifies and intervenes with high-risk patients requiring social services
• Participates as appropriate in scheduled Case and Disease Management Huddles to present information regarding member status, care coordination efforts, resources provided, and to provide guidance to fellow teammates regarding resources for members
• Documents social work interventions by inclusion of reports in medical records and referral management system as needed
• Participates on an assigned basis in educational training for teammates and providers related to the psychosocial aspects of physical and emotional illness/disability
• Develops a treatment plan or plan of care which includes arrangements for referral to services as appropriate

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:

• Full 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 accommodation
• Knowledge of CPT4/ICD 9 & 10/HCPCS codes
• 3+ years of previous job-related experience in a healthcare environment
• NM licensure providing ability to perform duties required of position, (i.e. LCSW)
• Demonstrated ability to counsel and/or consult; working knowledge of HMO’s, PPO’s, Medicare, Medicaid, and insurance plans
• Current BLS Certification
• Master’s degree or higher in healthcare related field and applicable licensure, (i.e. LCSW or other applicable licensure demonstrating appropriate scope of practice)
• PC proficient

Preferred Qualifications:

• Utilization Review or Case Management Certificate
• Demonstrated ability to communicate and interact professionally with co-workers, management patients, and Providers
• Certified Case Manager
• 2+ years of experience providing case management and/or utilization review functions within health plan or integrated system

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.


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.