UnitedHealth Group-posted 3 months ago
$28 - $50/Yr
Full-time • Entry Level
Remote • New Orleans, LA
Insurance Carriers and Related Activities

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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. If you are located within a commutable distance of New Orleans, LA market, you will have the flexibility to work remotely as you take on some tough challenges.

  • Serve as primary care manager for members with complex medical/behavioral needs
  • Engage members telephonically to complete a comprehensive needs assessment, including assessment of medical, functional, cultural and socioeconomic (SDOH) domains
  • Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines
  • Identify gaps or barriers in treatment plans
  • Partner and collaborate with internal care team, providers, community resources/partners and leverage expertise to implement care plan
  • Coordinate care for members and services as needed (home health, DME, etc.)
  • Provide education and coaching to support Member self-management of care needs in alignment with evidence-based guidelines; HEDIS/STAR gap closure
  • Provide education regarding conditions, medications/ medication adherence, provider/ treatment options, healthcare system utilization
  • Help identify presence or exacerbation of behavioral health symptoms that may be influencing / impacting physical health
  • Provide guidance / consultation to other team members regarding physical/behavioral health conditions, best practice and evidence
  • Current, unrestricted LA RN license
  • 3+ years of experience managing needs of complex populations (eg. Medicaid)
  • 2+ years of relevant clinical work experience
  • 1+ years of community case management experience coordinating care for individuals with complex needs
  • Applied knowledge of Medicaid benefits
  • Demonstrated ability to navigate a Windows environment, utilize Outlook, and the ability to create, edit, save and send documents utilizing Microsoft Word
  • Bachelor's Degree
  • 2+ years of behavioral health experience providing care for individuals with mental, emotional and substance use conditions, including therapeutic communication, crisis intervention, and collaborative treatment planning with a multidisciplinary team
  • Experience working in managed care/Home health care
  • Willingness to obtain Certified Case Manager (CCM) within a year
  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution
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