Remote Telephonic Case Manager RN NY

UnitedHealthcare

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Requisition Number: 2160126
Job Category: Medical & Clinical Operations
Primary Location: Brooklyn, NY
(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 and start doing your life’s best work.(sm)

In this Field Health & Social Service Clinical Coordinator role, you 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.

If you are located in the state of New York, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • Serve as primary care manager for members with complex medical/behavioral needs
  • Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, functional, cultural and socioeconomic (SDOH) domains
  • 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
  • Identify gaps or barriers in treatment plans
  • Partner and collaborate with internal care team, providers, community resources/partners and leverage expertise to implement care plan
  • Coordinate care for members and services as needed (home health, DME, etc.)
  • Provide education and coaching to support Member self-management of care needs in alignment with evidence-based guidelines; HEDIS/STAR gap closure
  • Provide psycho-education regarding conditions, medications/ medication adherence, provider/ treatment options, healthcare system utilization
  • Help identify presence or exacerbation of behavioral health symptoms that may be influencing / impacting physical health
  • Provide guidance / consultation to other team members regarding physical/behavioral health conditions, best practice and evidence

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 NY RN license
  • 4+ years of relevant clinical work experience
  • 3+ years of experience managing needs of complex populations (eg. Medicare, Medicaid)
  • 1+ years of relevant community case management experience coordinating care for individuals with complex needs
  • Demonstrate knowledge of Medicare and Medicaid benefits
  • Ability to navigate a Windows environment, utilize Outlook, and the ability to create, edit, save and send documents utilizing Microsoft Word

 

Preferred Qualifications:

  • Bachelor’s Degree
  • Certified Case Manager (CCM)
  • Experience working directly with individuals with behavioral health conditions (mental health / substance use disorders)
  • Demonstrated experience / additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care
  • Experience working in managed care

 

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That’s why you’ll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life’s best work.(sm)

 

New York Residents Only: The hourly range for New York residents is $27.07 to $53.08. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

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