Remote Field Care Coordinator: Complex-Needs Case Manager

Taleo; Sevierville (TN); Hybrid; USD 83,097,000 - 149,001,000; Full time

Job summary

UnitedHealth Group in Tennessee is seeking a Field Care Coordinator for Sevier County. This field-based role coordinates member care needs for medically complex individuals, applying clinical knowledge to ensure access to services and providers.

You will collaborate with Case Management, Utilization Review and Behavioral Health teams, perform telephonic and in-person assessments, educate members, and develop care plans while traveling up to 75% within the assigned territory.

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, including Word, Excel, and Outlook.
• Excellent organization, communication and time management skills.
• Ability to travel up to 75% within an assigned territory to meet with members and providers.
• Reside in or within a commutable driving distance to Sevier County.
• Access to reliable transportation and valid US driver's license.

Responsibilities

• Apply clinical knowledge to effect efficient case management for those accessing their Medicare/Medicaid benefits.
• Incorporate evidence-based clinical practices into care coordination activities.
• Deliver member-centered, individualized self-management support and patient education.
• Ensure appropriate utilization and consistent application of health benefits.
• Conduct telephonic and face-to-face assessments according to Health Plan policy and procedure.
• Serve as member advocate and facilitator to resolve issues that may be perceived as barriers to care.
• Provide education and coordination of community resource referrals to members and providers.
• Develop, implement, maintain and evaluate a member-centered, individual care plan when services are indicated.
• Collaborate with Care Coordination Team to improve quality and efficiency of care delivery.
• Monitor hospital encounters and provide education/interventions as necessary to reduce frequency.
• Refer clinical decisions beyond authority for review
• Participate in Health Plan Quality Improvement process
• Utilize Health Plan software to enter service requests, document, and monitor all aspects of member care coordination
• Maintain time sensitive documentation to assure compliance with regulatory agencies
• Coordinate services for members following Health plan policy
• Perform other duties as assigned

Skills

Time management

Organization

Communication

Education

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

Tools

MS Office (Word, Excel, Outlook)

Job description

UnitedHealth Group in Tennessee is seeking a Field Care Coordinator for Sevier County. This field-based role coordinates member care needs for medically complex individuals, applying clinical knowledge to ensure access to services and providers.

You will collaborate with Case Management, Utilization Review and Behavioral Health teams, perform telephonic and in-person assessments, educate members, and develop care plans while traveling up to 75% within the assigned territory.