Requisition Number: 2193653
Job Category: Medical & Clinical Operations
Primary Location: Monroe, LA
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.
HSS Clinical Coordinator provides telephonic, virtual, and field-based care coordination based on 3-tier model.
The foster care remote and field-based CM will be the primary care manager for foster care members. 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. This position is responsible for the children, in the care and custody of the state, managed by the health plan, including, and not limited to development and clinical oversight of SCYP (Supporting Connection for Young people through Empowerment).
This position is also responsible for serving as a liaison with state agencies, including and not limited to Department of Health, Department of Mental Health, Department of Developmental Resources, Office of Juvenile Justice, Department of Children and Family Services, Department of Elementary and Secondary Education, Medicaid Services, and consultation with the Health Plan about interaction and services to these departments.
This position is responsible for clinical and thought leadership related to children and families who interact with the child welfare and juvenile justice systems through foster care, adoptive assistance, former foster youth (through age 26) and youth in the custody of the juvenile justice system.
Your confidence, decisiveness and perseverance will help you positively impact our patient lives. Join us now and start doing your life’s best work.
This is a field-based position with a home-based office. You will work from home when not in the field. If you reside within a commutable distance of Monroe, Alexandria, Lafayette and Lake Charles, LA you will have the flexibility to work remotely as you take on some tough challenges.
If you reside within a commutable distance of Monroe, LA and surrounding areas, you will have the flexibility to work remotely* as you take on some tough challenges.
- Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs, including but not limited to assessing, planning, and implementing care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care
- 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, and manage the care plan throughout the continuum of care
- Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan, and identify, initiate, coordinate, and monitor referrals for psychosocial, behavioral, and medical services based on care integration needs
- Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
- Advocate for members and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team
- Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health, including but not limited to trauma-informed and disease/disorder specific education to members and caregivers
- Coordinate with the child welfare and juvenile justice system on behalf of members and caregivers
- Support proactive discharge planning and manage/coordinate Care Transition
- Proven ability to communicate complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
- Expect to spend about 25% 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, maintain patience in all types of situations
What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
- Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
- Medical Plan options along with participation in a Health Spending Account or a Health Saving account
- Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
- More information can be downloaded at: http://uhg.hr/uhgbenefits
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.
- Current, unrestricted license in the State of LA
- 2+ years nursing or social worker experience arranging community resources/case management in child and youth welfare or special health care needs population
- 2+ years working with pediatrics/children
- 2+ years of experience working with MS Word, Excel and Outlook
- Experience in Home and Community based or Long-Term Care services delivery
- Experience with electronic charting
- Intermediate proficiency with software applications to include Microsoft Word, Microsoft Excel, Microsoft PowerPoint and ability to use multiple web applications
- Computer/typing proficiency to enter/retrieve data in electronic clinical records, experience with email, internet research, use of online calendars
- Ability to travel locally approximately 25% of the time and up to 100 miles round trip with reliable transportation, that will enable you to travel to member sites within a designated area, with a current and non-restricted state of Louisiana driver’s license and state-required insurance
- Unrestricted LA driver’s License
- Reside in the state of LA
- Access to reliable transportation
- Proven ability to perform all essential job functions with or without reasonable accommodation
- CCM (Certified Case Manager)
- 2+ years working with individuals with behavioral health needs
- 2+ years working with the child welfare system (lived or learned)
- Experience working in Medicaid health care and insurance industry, including regulatory and compliance requirements
- Outpatient Prior Authorization/Outpatient Utilization Management experience
- Case Management experience
- Field-based work experience
- Knowledge of ICUE and Community care Programs
Location: Opportunities available throughout the state. This is a field-based position with a home-based office. You will work from home when not in the field.
*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.
Search by License
Search Jobs by State
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Rhode Island
- South Carolina
- South Dakota
- West Virginia
Remote nursing jobs delivered to your inbox once a week
Find your unicorn remote job
Join hundreds of nurses getting
weekly alerts with the best jobs!
Join hundreds of nurses getting
weekly alerts with the best jobs!