Remote Field Care Coordinator (Medicare/Medicaid)

UHC; Nashville (TN); Hybrid; USD 40,000 - 72,000; Full time

Job summary

UnitedHealthcare is seeking a Care Coordinator to apply clinical knowledge to coordinate complex member care, offering field-based flexibility for those in Davidson County. The role collaborates with Case Management, Utilization Review, and Behavioral Health teams to ensure access to services and cost-effective care.

Responsibilities include conducting assessments, education, care planning, and coordination with providers.

Qualifications

• Bachelor's degree in social work or related health care profession OR an LPN license is required.
• 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.
• Reside in or within a commutable driving distance to Davidson County.
• Access to reliable transportation and valid US driver's license with ability to travel up to 75% within an assigned territory to meet with members and providers.

Responsibilities

• Apply clinical knowledge to coordinate case management for Medicare/Medicaid members.
• Incorporate evidence-based clinical practices into care coordination.
• Deliver member-centered, self-management support and education.
• Ensure appropriate utilization and consistent health benefits application.
• Conduct telephonic and face-to-face assessments per policy and timelines.
• Advocate for members to resolve barriers to care.
• Coordinate referrals to community resources for members and providers.
• Develop and maintain member-centered care plans as needed.
• Collaborate with Care Coordination Team to improve care quality and efficiency.
• Monitor hospital encounters and provide interventions to reduce frequency.
• Refer non-authority decisions for review.
• Participate in Quality Improvement processes and document activities.
• Use Health Plan software to enter service requests and document care.
• Maintain time-sensitive documentation for regulatory compliance.
• Coordinate services per Health plan policy.
• Perform other duties as assigned.

Skills

Case management

Organization

Communication

Time management

Education

Bachelor's degree / related health care

LPN license

Tools

MS Office

Job description

UnitedHealthcare is seeking a Care Coordinator to apply clinical knowledge to coordinate complex member care, offering field-based flexibility for those in Davidson County. The role collaborates with Case Management, Utilization Review, and Behavioral Health teams to ensure access to services and cost-effective care.

Responsibilities include conducting assessments, education, care planning, and coordination with providers.