Remote Field Care Navigator - Medicare/Medicaid

UHC; Athens (LA); Remote; USD 40,000 - 72,000; Full time

Job summary

UnitedHealthcare seeks a Care Coordinator to apply clinical knowledge to coordinate care for medically complex members, ensuring access to services and providers across the continuum.

This field-based role requires travel up to 75% within the assigned territory and offers remote work flexibility for eligible locations; you will collaborate with Case Management, Utilization Review and Behavioral Health teams.

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 MS Office, including Word, Excel, and Outlook.
• Excellent organization, communication and time management skills.
• Reside in or within a commutable driving distance to Hamilton, Bradley, and McMinn Counties.
• Access to reliable transportation and valid US driver's license with the ability to travel up to 75% within an assigned territory to meet with members and providers.

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
• 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
• Monitor hospital encounters and provide education/interventions to reduce frequency
• Refer clinical decisions beyond authority to manager for review
• Participate in Health Plan Quality Improvement process
• Utilize Health Plan software to enter service requests and monitor care coordination
• Maintain time sensitive documentation for regulatory compliance
• Coordinate services following Health plan policy
• Perform other duties as assigned

Skills

Organization

Communication

Time management

Travel readiness

Case management experience

MS Office

Education

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

LCSW, LBSW, Master's degree in Clinical Field

Job description

UnitedHealthcare seeks a Care Coordinator to apply clinical knowledge to coordinate care for medically complex members, ensuring access to services and providers across the continuum.

This field-based role requires travel up to 75% within the assigned territory and offers remote work flexibility for eligible locations; you will collaborate with Case Management, Utilization Review and Behavioral Health teams.