Field Care Coordinator – Medicare/Medicaid

UnitedHealth Group; Brentwood (TN); Hybrid; USD 40,000 - 72,000; Full time

Job summary

UnitedHealthcare, a part of UnitedHealth Group, is seeking a Care Coordinator to coordinate care for medically complex members. This field-based role requires travel within Sevier County and surrounding areas, delivering patient education and coordinating services across the continuum.

You will work with the Care Coordination team to ensure timely access, documentation, and adherence to CMSA case management practices, with a focus on cost-effective care delivery.

Qualifications

• Bachelor's degree in Social Work, Nursing or other health care profession including LPN.
• 2+ years of clinical case management experience.
• Travel up to 75% within an assigned territory to meet with members and providers.
• Reside in or within commutable driving distance to Sevier County.

Responsibilities

• Apply clinical knowledge to effect efficient case management for Medicare/Medicaid members.
• Incorporate evidence-based clinical practices into care coordination.
• Deliver member-centered self-management support and patient education.
• Ensure appropriate utilization and consistent health benefits application.
• Conduct telephonic and face-to-face assessments with documentation.
• Serve as member advocate to resolve access barriers to care.
• Coordinate community resource referrals for members and providers.
• Develop and maintain member-centered care plans in collaboration with families and providers.
• Collaborate with Care Coordination team to improve health care delivery.
• Monitor hospital encounters and provide interventions to reduce frequency.
• Refer clinical decisions beyond authority to manager for review.
• Support Health Plan Quality Improvement processes; report issues for resolution.
• Use Health Plan software to document service requests and care delivery.
• Maintain time-sensitive documentation for regulatory compliance.
• Coordinate services following Health Plan policy.
• Perform other duties as assigned.

Skills

Communication

Time management

Travel readiness

Team collaboration

Education

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

LCSW, LBSW, Master's degree in Clinical Field

CCM certification

Tools

MS Office

Job description

UnitedHealthcare, a part of UnitedHealth Group, is seeking a Care Coordinator to coordinate care for medically complex members. This field-based role requires travel within Sevier County and surrounding areas, delivering patient education and coordinating services across the continuum.

You will work with the Care Coordination team to ensure timely access, documentation, and adherence to CMSA case management practices, with a focus on cost-effective care delivery.