HSS Clinical Coordinator, RN - Remote in Texas

UnitedHealth Group•Houston, TX

20h•$29 - $52•Remote

About The Position

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. In this Field Care Coordinator RN role, will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs. If you reside in Texas, you will have the flexibility to work remotely as you take on some tough challenges. 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.

Requirements

Current RN unrestricted license in the State of TX or a compact RN license
2+ years of experience working within the community health setting or in a health care role
2+ years of experience working in community health, clinical, hospital, acute care, direct care or case management setting
2+ years of experience working with MS Word, Excel, and Outlook
High-speed internet at residence
Must live within a 60 mile commutable driving distance to a UHG office
Reside in the state of Texas

Nice To Haves

1+ years of experience with long term care services and support, Medicaid, or Medicare
Knowledge of the principles of most integrated settings, including federal and state requirements like the federal home and community-based settings regulations
Proven ability to create, edit, save and send documents, spreadsheets and emails

Responsibilities

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care
Utilize both company and community-based resources to establish a safe and effective case management plan for members
Collaborate with patient, family, and healthcare providers to develop an individualized plan of care
Identify and initiate referrals for social service programs, including financial, psychosocial, community, and state supportive services
Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the healthcare team
Utilize approved clinical criteria to assess and determine appropriate level of care for members
Document all member assessments, care plan and referrals provided
Participate in Interdisciplinary team meetings and Utilization Management rounds and provide information to assist with safe transitions of care
Understand insurance products, benefits, coverage limitations, insurance, and governmental regulations as it applies to the health plan
Accountable to understand role and how it affects utilization management benchmarks and quality outcomes