Remote Transition Care Coordinator (Medically Complex Members)

UnitedHealthcare; Nashville (TN); Remote; USD 40,000 - 72,000; Full time

Job summary

UnitedHealthcare is seeking a Transition Care Coordinator to apply clinical knowledge to coordinate member transitions between care settings for medically complex individuals, ensuring access to services and cost-effective care.

This field-based role requires travel up to 50% within the assigned territory and can be remote within commuting distance to Wilson, Smith, and Davidson Counties. The team collaborates across care coordination to improve outcomes.

Qualifications

• Current Nursing License (RN) or LBSW License
• 2+ years of clinical experience as an RN or LBSW
• 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 Wilson, Smith, and Davidson Counties
• Access to reliable transportation and valid US driver's license with the ability to travel up to 50% within an assigned territory to meet with members and providers

Responsibilities

• Apply clinical knowledge to effect efficient case management for those accessing Medicare/Medicaid benefits
• Incorporate 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 and services
• Conduct telephonic and face to face assessments per policy and procedure
• Serve as member advocate and facilitator to resolve barriers to care
• Provide education and coordination of community resource referrals
• Develop member-centered care plans based on needs and proactive collaboration
• Collaborate with Care Coordination Team to improve quality and efficiency of care
• Monitor hospital encounters and evaluate safety during transitions
• Refer complex decisions to manager for review
• Participate in Quality Improvement processes and document accordingly
• Utilize Health Plan software to enter service requests and monitor care
• Maintain time-sensitive documentation for regulatory compliance
• Coordinate services following Health plan policy
• Perform other duties as assigned

Skills

Communication

Organization

Time management

Travel readiness

Education

RN/LBSW license

BSN or MSW preferred

Tools

MS Office

Job description

UnitedHealthcare is seeking a Transition Care Coordinator to apply clinical knowledge to coordinate member transitions between care settings for medically complex individuals, ensuring access to services and cost-effective care.

This field-based role requires travel up to 50% within the assigned territory and can be remote within commuting distance to Wilson, Smith, and Davidson Counties. The team collaborates across care coordination to improve outcomes.