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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
The RN Clinical Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting member’s medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care.
If you are located in Louisiana, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs
Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines
Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan
Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health
Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission
Advocate for members and families as needed to ensure the member’s needs and choices are fully represented and supported by the health care team
Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate level of care
Identify, initiate, coordinate, and monitor referrals for psychosocial, behavioral, and medical services
Manage the care plan throughout the continuum of care as a point of contact
Communicate with stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team
Adhere to meeting, goal targets as identified my management on an ongoing basis: Weekly, Monthly, and Quarterly
Assesses and interprets customer needs and requirements
Identifies solutions to non-standard requests and problems
Problem solve members moderate to complex problems for optimal healthcare outcomes
Work with minimal guidance and ability to seek guidance when necessary and / or identified for complex tasks
Ability to translates concepts into practice
Coaches, provides feedback, and guides others.
Acts as a resource and preceptor for others as needed
Participate in all required Learn source and training as identified by management
Adhere and operate according to organization policies and procedures for Clinical Services
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:
Current, unrestricted independent licensure as a Registered Nurse in state LA
2+ years of clinical experience
Proven intermediate proficiency in software applications to include Microsoft Word, Microsoft Excel, Microsoft PowerPoint
Computer proficiency to enter/retrieve data in electronic clinical records, experience with email, internet research, use of online calendars
Experience with electronic charting
Access to reliable transportation and the ability to travel within assigned territory to meet with members and providers
Reside in the state of LA
Preferred Qualifications:
CCM (Certified Case Manager)
RN with 3+ years clinical experience
1+ years Case Management experience
2+ years of community case management experience coordinating care for individuals with complex needs
Background in Managed Care
Field-based work experience
Experience working in Medicaid health care and insurance industry, including regulatory and compliance requirements
*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.