HSS Clinical Coordinator - RN - Complex Care - UHC C&S ABD, LTC - Remote from Sugarland, TX

UnitedHealth Group; Sugar Land (TX); Remote; USD 70,000 - 90,000; Full time

Job summary

Join a leading healthcare company as an HSS Clinical Coordinator - RN, focusing on complex care. This role allows remote work from Sugarland, TX, and involves assessing patient needs, coordinating care, and advocating for patients. Ideal candidates have extensive community health experience and an active RN license in Texas.

Qualifications

• 4+ years in community health or clinical settings.
• Must live within 60 miles of Sugarland, TX.

Responsibilities

• Assess and implement individualized care strategies.
• Collaborate with patients and healthcare providers.
• Manage care plans and document assessments.

Skills

Community Health

Patient Advocacy

Care Coordination

Education

Active RN License in TX

Tools

MS Word

Excel

Outlook

Job description

HSS Clinical Coordinator - RN - Complex Care - UHC C&S ABD, LTC - Remote from Sugarland, TX

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)

This function is for UHC C&S Only (with the exception of the Community Health Worker role). Positions in this function address efforts focused on medical, behavioral, and social determinants of health factors that improve the well-being of individuals, families, and communities.

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

If you are located within 60 miles of Sugarland, Texas, you’ll enjoy the flexibility to work remotely * from anywhere within the U.S. 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, lease 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
• Manage care plan throughout the continuum of care as a single point of contact
• 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

Expect to spend about 75% 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, 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 of experience working in a community health, clinical, hospital, acute care, direct care or case management setting
• 2+ years of experience working with MS Word, Excel and Outlook
• Must live within a 60 mile radius to a UHG office (Sugarland Texas)

Preferred Qualifications:

• Experience with electronic charting
• Experience with arranging community resources
• Field based work experience
• Pediatric experience
• Behavioral Health experience
• Background in managing populations with complex medical or behavioral needs
• Willing or ability to travel in assigned region to visit Medicaid members in their homes and / or other settings, including community centers, hospitals or providers' offices

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)

*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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

About the company

UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota.