Field Care Coordinator — Complex Case Management

UnitedHealthcare; Maryville (TN); Hybrid; USD 40,000 - 72,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

Equity stock purchase

401k contribution

Job summary

UnitedHealthcare is seeking a Care Coordinator to apply clinical knowledge and coordinate intensive care needs for medically complex members. You will work with the Care Coordination team across case management, utilization review, and behavioral health to ensure access to services and cost-effective care.

This field-based role may offer remote work within commutable distance to Blount County, TN, and requires up to 75% travel within the territory to meet with members and providers.

Qualifications

• Bachelor's degree in Social Work, Nursing or other health care profession including LPN.
• 2+ years of clinical case management experience.
• 1+ years of experience with MS Office (Word, Excel, Outlook).
• Strong organization, communication and time management skills.
• Ability to travel up to 75% within an assigned territory to meet members/providers.
• Reside in or within commutable distance to Sevier County.

Responsibilities

• Apply clinical knowledge to efficient case management for Medicare/Medicaid members.
• Incorporate evidence-based clinical practices into care coordination.
• Deliver member-centered, individualized self-management support and education.
• Ensure appropriate utilization and consistent health benefits application.
• Conduct telephonic and face-to-face assessments per policy and timeframes.
• Advocate for members and resolve barriers to care.
• Coordinate community resource referrals to members/providers.
• Develop and maintain member-centered care plans.
• Collaborate with Care Coordination Team to improve quality/efficiency.
• Monitor hospital encounters and provide education/interventions to reduce frequency.
• Refer decisions beyond authority to manager for review.
• Participate in Health Plan Quality Improvement activities.
• Use Health Plan software to log service requests and document care coordination.
• Maintain time-sensitive documentation for regulatory compliance.
• Coordinate services per Health plan policy.
• Perform other duties as assigned.

Skills

Excellent organization

Communication

Time management

Travel ability

Reliable transportation

Education

Bachelor's degree in Social Work, Nursing or other health care profession including LPN

Tools

MS Office

Job description

UnitedHealthcare is seeking a Care Coordinator to apply clinical knowledge and coordinate intensive care needs for medically complex members. You will work with the Care Coordination team across case management, utilization review, and behavioral health to ensure access to services and cost-effective care.

This field-based role may offer remote work within commutable distance to Blount County, TN, and requires up to 75% travel within the territory to meet with members and providers.