Remote Field Care Coordinator: Medically Complex Care

Optum; Chattanooga (TN); Remote; USD 40,000 - 72,000; Full time

Benefits offered by this job

Benefits package

401k contribution

Equity stock purchase

Job summary

UnitedHealth Group is seeking an experienced Care Coordinator to apply clinical knowledge in coordinating care for medically complex members. You will support access to services, educate patients, and document care plans across acute, home, and chronic settings.

The role emphasizes collaboration with Case Management, Utilization Review, and Behavioral Health teams. Travel up to 75% within assigned territory is required to meet members and providers, with remote work flexibility for commuting

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.

Responsibilities

• Application of clinical knowledge to effect efficient case management for those accessing their Medicare/Medicaid benefits.
• Incorporates evidence-based clinical practices into care coordination activities.
• Delivers member-centered, individualized self-management support and patient education.
• Ensure appropriate utilization and consistent application of the health benefits.
• Conduct telephonic and face to face assessments according to Health Plan policy and procedure, including system documentation and State prescribed timeframes.
• 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, based on member care needs identified through proactive collaboration and communication with members, families and providers.
• Collaborate and communicate with other members of the Care Coordination Team to improve the quality and efficiency of health care delivery and ensure smooth transition of care coordination activities to other team members.
• Monitor hospital encounters of assigned members and provide education and/or interventions as necessary to reduce frequency.
• Refer clinical decisions beyond level of authority for members who do not meet established criteria to manager for review and decision.
• Participate in the Health Plan Quality Improvement process including recognition of quality-of-care issues and forward information to appropriate staff for review and resolution.
• Utilize Health Plan software to enter service requests, document, and monitor all aspects of member care coordination and service delivery.
• Maintain time sensitive documentation to assure compliance with regulatory agencies.
• Coordinate services for members following Health plan policy.
• Perform other duties as assigned

Skills

Case management

Interpersonal skills

Documentation

Communication

Education

Bachelor's degree in health care

Tools

MS Office

Outlook

Job description

UnitedHealth Group is seeking an experienced Care Coordinator to apply clinical knowledge in coordinating care for medically complex members. You will support access to services, educate patients, and document care plans across acute, home, and chronic settings.

The role emphasizes collaboration with Case Management, Utilization Review, and Behavioral Health teams. Travel up to 75% within assigned territory is required to meet members and providers, with remote work flexibility for commuting