Remote Field Care Coordinator – Medicare/Medicaid

Jobtome; Maryville (TN); Hybrid; USD 40,000 - 72,000; Full time

Job summary

UnitedHealthcare is seeking a Care Coordinator to apply clinical knowledge in coordinating care for medically complex members. You will collaborate with Case Management, Utilization Review, and Behavioral Health teams to ensure access to services and optimal care across acute, home, and community settings.

The role is field-based with remote work flexibility for those within commutable distance to Blount County, Tennessee, and requires up to 75% travel within the 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 (Word, Excel, 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 a valid US driver's license.

Responsibilities

• Application of clinical knowledge to coordinate member care needs for medically complex individuals.
• Incorporates 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 in line with policy and timelines.
• Serve as member advocate to resolve barriers to care.
• Provide education and coordination of community resource referrals.
• Develop and maintain a member-centered care plan.
• Collaborate with Care Coordination team to improve care quality and efficiency.
• Monitor hospital encounters to reduce frequency; refer non-conforming cases to manager.
• Participate in Health Plan Quality Improvement processes.
• Utilize Health Plan software to document and monitor care coordination activities.
• Maintain time-sensitive documentation to comply with regulatory agencies.
• Coordinate services as per Health Plan policy.

Skills

clinical case management

MS Office suite

organization & time management

travel up to 75%

Sevier County resident commuting

valid US driver's license

Education

Bachelor's degree in Social Work, Nursing or related health care field including LPN

CCM certification

LCSW/LBSW or Master's in Clinical Field

Job description

UnitedHealthcare is seeking a Care Coordinator to apply clinical knowledge in coordinating care for medically complex members. You will collaborate with Case Management, Utilization Review, and Behavioral Health teams to ensure access to services and optimal care across acute, home, and community settings.

The role is field-based with remote work flexibility for those within commutable distance to Blount County, Tennessee, and requires up to 75% travel within the territory.