Remote RN Care Coordinator – Hybrid Role in TX

UnitedHealthcare

Apply Now

Get FREE Email Templates to boost your job search!

 

Please take 3-minutes to complete our survey about LinkedIn, and we’ll send these templates straight to your inbox!

 

Thank you 👉  Click here for the survey

Requisition Number: 2182708
Job Category: Medical & Clinical Operations
Primary Location: Houston, 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. 

 

On the UHC Community & State Complex Care Management team, this TX Registered Nurse will address efforts focused on medical, behavioral, and social determinants of health factors that improve the well-being of individuals, families, and communities. Within the scope of nursing practice, this RN will be an essential element of an Integrated Care Model by relaying pertinent information about the member needs and advocating for the best possible care available.

 

  • Generally, work is self-directed and not prescribed
  • Works with less structured, more complex issues
  • Serves as a resource to others

 

They will telephonically work directly with a diverse population of members to assist with unmet needs, closing gaps in care, reducing risk for ER and hospital utilization, identifying appropriate referral needs, and providing education on disease management and preventive health care to empower patients to manage their chronic health conditions.

 

If you reside in the state of Texas, you will have the flexibility to work remotely* as you take on some tough challenges!

 

Primary Responsibilities: 

  • Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least 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
  • 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
  • Understand role and how it affects utilization management benchmarks and quality outcomes

 

You’ll need to be flexible, adaptable and, above all, patient in all types of situations!

 

Demonstrated Skills:

  • Solid, interpersonal, relationship-building skills
  • Able to communicate effectively written and verbal in a professional manner
  • Ability to work in a self-directed manner within a fast-paced, deadline-driven environment
  • Proactively seeks guidance on complex tasks, as needed
  • Client focus and ability to adapt style and approach to customer preferences
  • Problem resolution and time management skills
  • Remain flexible, adaptable, and 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 RN license in the state of TX
  • 4+ years of experience working within the community health setting in a health care role
  • 4+ years diversified clinical nursing experience, including medical/surgical nursing, case management or home care
  • Proficiency in MS Office (Word, Excel, PowerPoint, Outlook, Teams)
  • Proficient with technology resources (computers/mobile devices, Internet, social media platforms & networks, software applications, virtual presence, etc.)
  • Have a designated quiet workspace and access to install secure high-speed internet via cable/DSL in home
  • This is a non-exempt/hourly paid role. Must be willing to work core business hours Mon-Fri, 8:00am – 5:00pm (CT) and overtime, when required at the request of the business
  • Expect to travel up to 25% of time in the field, visiting our members in their homes, long term care (LTC), or other approved facilities
  • Must reside within 60 miles of our UHG Office

 

Preferred Qualifications:

  • BSN – Bachelor of Science in Nursing
  • Experience with electronic charting
  • Experience collaborating with communities of all different ethnicities, cultural backgrounds, diverse populations and/or underserved communities
  • Experience with arranging community resources
  • Pediatric experience
  • Behavioral health experience
  • Field based work experience
  • Background in managing populations with complex medical or behavioral needs
  • Demonstrated knowledge of Medicaid, TX STAR Kids, STAR, CHIP
  • Proficiency in CMS marketing rules and regulations
  • Bilingual

 

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