RN Clinical Coordinator - Remote in New Jersey

Optum; United States; Remote; USD 55,000 - 74,000; Full time

Benefits offered by this job

Comprehensive benefits package

401k contribution

Equity stock purchase program

Job summary

UnitedHealthcare is seeking an HSS Clinical Coordinator RN to serve as the primary care manager for a panel of members with complex health needs, including behavioral health, with a focus on coordinating medical, behavioral, and social determinants of health services.

The role involves engaging with members, developing individualized care plans, and collaborating with internal teams and community resources to improve health outcomes.

Qualifications

• Current, unrestricted RN license in New Jersey.
• 2+ years RN hospital/acute care or case management experience.
• 1+ years with elderly or disabled in institutional/community settings.
• 1+ years in long-term care, home health, hospice, public health or assisted living.

Responsibilities

• Serve as primary care manager for high medical risk members with behavioral health needs.
• Conduct comprehensive needs assessments covering medical, behavioral, functional, cultural, and socioeconomic needs.
• Develop and implement person-centered care plans with goals and interventions.
• Collaborate with care team, providers and community resources to implement care plans.
• Provide referrals and linkage to appropriate internal/external resources.

Skills

RN license

Case management

Outlook

MS Word

MS Excel

Communication

Bilingual English/Spanish

Education

RN Bachelor degree preferred

CCM certification (preferred)

Tools

Outlook

Word

Excel

Job description

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

As part of a care management team who will manage complex members, the HSS Clinical Coordinator RN will be the primary care manager for a panel of members with complex health needs (i.e., developmental, mental health or substance use disorders). Additionally, this position will provide behavioral health support to the broader team. Care coordination activities will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care.

If you are located within the New Jersey territory and willing to travel up to 10% of your time to assigned territory, you will have the flexibility to work remotely as you take on some tough challenges.

Primary Responsibilities:

• Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs
• Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs
• Develop and implement individualized, person-centered care plans inclusive of goals, opportunities and interventions aligned with a person's readiness to change to support the best health and quality of life outcomes by meeting the member where they are
• Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan
• Provide referral and linkage as appropriate and accepted by member (may include internal consult opportunities such as Housing Navigator, Pharmacy Team, Peer Specialist, etc. or community-based provider referrals such as PCP, specialists, medication assisted therapy referrals, etc.)

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Current, unrestricted RN license in New Jersey
• 2+ years of RN experience in a hospital setting, acute care, direct care experience and/or experience as a Case Manager
• 1+ years of paid professional experience working directly with the elderly or physically disabled in an institutional or community setting
• 1+ years of experience in long-term care, home health, hospice, public health or assisted living
• Proven ability to navigate a Windows environment, utilize Outlook, and the ability to create, edit, save and send documents utilizing Microsoft Word and Excel
• Demonstrated ability to talk and type proficiently at the same time

Preferred Qualifications:

• Bachelor's degree or greater
• Certified Case Manager (CCM)
• Experience with working with DSNP
• Experience working with populations with special needs
• Experience/exposure with discharge planning
• Experience in utilization review, concurrent review and/or risk management
• Experience with government health programs (Medicaid / Medicare)
• Case Management experience
• Background in managed care
• Proven Bilingual - English/Spanish
• Proven solid organizational skills and multitasking abilities

Physical Requirement:

• Ability to remain stationary for long periods of time to complete computer or tablet work duties

All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.

• we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

The hourly pay for this role will range from $40 to $54 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.