Remote Field Care Coordinator – Complex Patient Advocate

Optum; Brownsville (TN); Hybrid; USD 40,000 - 72,000; Full time

Benefits offered by this job

Comprehensive benefits package

401k contribution

Stock purchase program

Job summary

UnitedHealthcare seeks a Care Coordinator to coordinate complex member care across acute, home, chronic, and alternative settings. You will use clinical knowledge to manage cases, educate members, and ensure access to services, working closely with Case Management, Utilization Review and Behavioral Health teams.

The role requires a Bachelor’s in a health-related field, 2+ years of case management, and ability to travel up to 75%. Telework options are available within the field-based framework.

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)
• Reside in or within commutable driving distance to Haywood County, TN
• Access to reliable transportation and valid US driver’s license; ability to travel up to 75% within territory

Responsibilities

• Apply clinical knowledge to effect efficient case management for Medicare/Medicaid benefits
• Incorporate evidence-based clinical practices into care coordination
• 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 per policy, with timely documentation
• Serve as member advocate to resolve barriers to care
• Coordinate referrals to community resources for members/providers
• Develop and maintain a member-centered care plan
• Collaborate with Care Coordination Team to improve care delivery
• Monitor hospital encounters and provide education/interventions as needed
• Refer decisions beyond authority to manager for review
• Participate in Health Plan Quality Improvement processes
• Use Health Plan software to document and monitor care coordination
• Maintain time-sensitive documentation for regulatory compliance
• Coordinate services per Health Plan policy
• Perform other duties as assigned

Skills

Organization skills

Communication skills

Time management

Education

Bachelor's degree in social work, nursing or other health care profession

LCSW/LBSW or Master's in Clinical Field (preferred)

Tools

MS Office

Job description

UnitedHealthcare seeks a Care Coordinator to coordinate complex member care across acute, home, chronic, and alternative settings. You will use clinical knowledge to manage cases, educate members, and ensure access to services, working closely with Case Management, Utilization Review and Behavioral Health teams.

The role requires a Bachelor’s in a health-related field, 2+ years of case management, and ability to travel up to 75%. Telework options are available within the field-based framework.