Remote Hybrid HSS Coordinator-LVN – College Station, TX

UnitedHealthcare

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Requisition Number: 2219508
Job Category: Medical & Clinical Operations
Primary Location: College Station, 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.

In this HSS Coordinator-LVN role, will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs.

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

If you reside within 30-50 miles from College Station, TX market you will have the flexibility to work a field schedule as you take on some tough challenges.

  • 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:

  • Active, unrestricted LVN license in the state of TX
  • 2+ years of experience working within the community health setting in a health care role including hospice
  • 2+ years of experience working in a community health, clinical, hospital, acute care, direct care or case management setting
  • Intermediate level of proficiency with MS Word, Excel and Outlook
  • Ability to travel in assigned region to visit Medicaid members in their homes and / or other settings, including community centers, hospitals or providers’ offices

Preferred Qualifications:

  • Background in managing populations with complex medical or behavioral needs
  • Experience with electronic charting
  • Experience with arranging community resources
  • Prior field-based work experience
  • Pediatric experience
  • Behavioral Health Experience
  • Community centers, hospitals, or providers’ offices

*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.