Field Care Coordinator - Sevier County

UnitedHealth Group•Brentwood, TN

10d•$29 - $52•Remote

About The Position

The Field Care Coordinator applies clinical knowledge to coordinate care for assigned members, primarily those with medically complex needs requiring intensive medical and psychosocial support. The coordinator works directly with members to ensure appropriate access to services and providers, identifying health risks early and supporting education, prevention, and care coordination across the continuum. The role helps arrange appropriate services in acute, home, chronic, and alternative care settings in a cost-effective manner, collaborating with Case Management, Utilization Review, and Behavioral Health team members. This is a field-based, remote-eligible role for candidates who live in or within commutable driving distance of Sevier County. The position requires travel within an assigned territory to meet members and providers. Telecommuters must adhere to UnitedHealth Group’s Telecommuter Policy.

Requirements

Bachelor’s degree in Social Work, Nursing, or another health care profession, including LPN.
At least 2 years of clinical case management experience.
At least 1 year of experience with MS Office, including Word, Excel, and 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 of Sevier County.
Access to reliable transportation and a valid U.S. driver’s license.
Adhere to UnitedHealth Group’s Telecommuter Policy if working remotely.
Pass a drug test before beginning employment.

Nice To Haves

LCSW or LBSW licensure, or a master’s degree in a clinical field.
CCM certification.
At least 1 year of community case management experience coordinating care for individuals with complex needs.
Long-term care experience.
Experience working in team-based care.
Working knowledge of Medicare and Medicaid regulations.
Working knowledge of medical terminology.

Responsibilities

Apply clinical knowledge to support efficient case management for members accessing Medicare and 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.
Conduct telephonic and face-to-face assessments according to Health Plan policy and procedure, including system documentation and state-prescribed timeframes.
Advocate for members and facilitate resolution of issues that may be barriers to care.
Educate members and providers and coordinate referrals to community resources.
Develop, implement, maintain, and evaluate individual member-centered care plans when indicated, based on identified needs and collaboration with members, families, and providers.
Collaborate and communicate with Care Coordination Team members to improve quality and efficiency and ensure smooth transitions of care coordination activities.
Monitor hospital encounters of assigned members and provide education or interventions as needed to reduce their frequency.
Refer clinical decisions beyond the role’s level of authority to a manager for review and decision when members do not meet established criteria.
Participate in Health Plan quality improvement, recognize quality-of-care issues, and forward information for review and resolution.
Use Health Plan software to enter service requests and document and monitor member care coordination and service delivery.
Maintain time-sensitive documentation to ensure compliance with regulatory agencies.
Coordinate services for members according to Health Plan policy.
Perform other duties as assigned.