Regional Transitional Care Manager - Western, VA Markets

UnitedHealth Group•Charlottesville, VA

6h•$24 - $43•Hybrid

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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. This role requires travel to various Nursing Facilities and Members homes. This is a Field Based role with a Home Based Office. For consideration, you must reside within the Western VA Markets. If you reside within a commutable distance of Western, VA Markets, you will have the flexibility to work remotely as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. The role requires travel throughout Western VA Markets visiting Nursing Facilities as well as our members who are transitioning to new locations in that market. 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

Social Worker with BSW degree or LPN with current/unrestricted license in Virginia
3+ years of care coordination or behavioral health experience and/or work in a healthcare environment
1+ years of experience directly working with individuals with complex medical or behavioral needs
Proficient computer skills in Microsoft Office to include Word, Outlook and the ability to type and talk at the same time and toggle between multiple screens
Demonstrate the ability to communicate with members who have complex medical needs, the elderly, individuals with physical disabilities, and/or those who may have communication barriers
Demonstrate ability to communicate and collaborate with multiple stakeholders on the implementation the transition plan
Driver’s License and access to reliable transportation

Nice To Haves

LSW/LCSW
Certified Case Manager
Experience managing transitions between care setting, including transition from nursing facility care to care in the community
Experience providing care coordination to persons receiving long-term care and/or home and community based services
Experience working with Medicaid/Medicare population
Long term care/geriatric experience
Case management experience in a clinical setting (hospital, long term care, home health, hospice) or managed care

Responsibilities

Participate in discharge planning for Members transitioning from LTC facility settings to the community
Coordinate with Utilization Management staff, as indicated regarding discharge planning
Collaborate and Coordinate with Nursing Facility staff, the Member’s assigned care coordinator, and the Member when it is identified that the Member wishes to transition from NF care to the community
Provide support to care coordinators to maintain Members in the community in lieu of transitioning to institutional settings, as needed
Collaborate and partner with community resources (e.g. CILs, CSBs, AAAs, etc.) and work with staff to facilitate safe transitions for members willing and able to transition from custodial NF care back to a community setting of their choice
Provide consistent follow up during the first year after discharge and shall make adjustments to the transition plan to assure acclimation and integration into the community as needed by the Member
For Dual eligible members enrolled in a DSNP, the Regional Transition Coordinator shall also work with the DSNP care coordinator upon approval of the Member, to coordinate the above activities
Review daily census, prioritizes daily work and monitor progress of transitions in accordance with Care Coordination policies
Actively collaborate and communicate with physicians and providers to arrange appropriate follow up, discharge planning and/or alternative care and services for plan members
Coordinate the authorization process for discharge planning needs in accordance with Plan policy and procedure
Participate in NF ICT/ Care Team meetings as appropriate; NF Rounds, Quarterly team meetings with NF CC and other meetings as required to facilitate transitions
Coordinate transition of members to other Level Care Coordinators as indicated
Perform other delegated duties as assigned