Remote Hybrid HSS Clinical Coordinator RN – Tarrant County, TX

UnitedHealthcare

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Requisition Number: 2217752
Job Category: Medical & Clinical Operations
Primary Location: Fort Worth, TX
(Remote considered)

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.

If you are located within 30-50 miles of within Tarrant County, TX, you will have the flexibility to work remotely* as you take on some tough challenges.

This is a Field Based role with a Home-Based office.

  • Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care
  • Utilize both company and community-based resources to establish a safe and effective case management plan for members
  • Collaborate with patient, family, and healthcare providers to develop an individualized plan of care
  • Identify and initiate referrals for social service programs; including financial, psychosocial, community, and state supportive services
  • Manage care plan throughout the continuum of care as a single point of contact
  • Communicate with all 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 healthcare team
  • Utilize approved clinical criteria to assess and determine appropriate level of care for members
  • Document all member assessments, care plan and referrals provided
  • Participate in Interdisciplinary team meetings and Utilization Management rounds and provide information to assist with safe transitions of care
  • Understand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health plan
  • Accountable to understand role and how it affects utilization management benchmarks and quality outcomes
  • Expect to spend about 75% of your time in the field 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

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 RN license in the state of Texas
  • 2+ years of experience working within the community health setting or in a healthcare role
  • Familiarity with Microsoft Office, including Word, Excel, and Outlook
  • Reliable transportation and the ability to travel in this ‘assigned region’ to visit Medicaid members in their homes and/or other settings, including community centers, hospitals, nursing facilities or providers’ offices
  • High-speed internet at residence

Preferred Qualifications:

  • 1+ years of experience with long term care services and support, Medicaid or Medicare
  • Ability to create, edit, save and send documents, spreadsheets and emails
  • Knowledge of the principles of most integrated settings, including federal and State requirements like the federal home and community-based settings regulations
  • Reside within commutable distance of assigned duties

*All Telecommuters 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.