RN Care Coordinator - Disease Management, Remote in TX

UnitedHealth Group•Houston, TX

2d•$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. On the UHC Community & State Complex Care Management team, this TX Registered Nurse will address efforts focused on medical, behavioral, and social determinants of health factors that improve the well-being of individuals, families, and communities. Within the scope of nursing practice, this RN will be an essential element of an Integrated Care Model by relaying pertinent information about the member needs and advocating for the best possible care available. Generally work is self-directed and not prescribed Works with less structured, more complex issues Serves as a resource to others He/she/they will telephonically work directly with a diverse population of members to assist with unmet needs, closing gaps in care, reducing risk for ER and hospital utilization, identifying appropriate referral needs, and providing education on disease management and preventive health care to empower patients to manage their chronic health conditions. If you are located in the state of Texas, preferably Harris County, you will have the flexibility to work remotely as you take on some tough challenges with the travel up to 25%25 of time in the field, visiting our members in their homes, long term care (LTC), or other approved facilities. You’ll need to be flexible, adaptable and, above all, patient in all types of situations What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: http://uhg.hr/uhgbenefits 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

Active, unrestricted RN license in the state of Texas
2+ years of experience working within the community health setting in a health care role
Intermediate level of proficiency in MS Office (Word, Excel, PowerPoint, Outlook, Teams)
Intermediate level of proficiency with technology resources (computers/mobile devices, Internet, social media platforms & networks, software applications, virtual presence, etc.)
Have a designated quiet workspace and access to install secure high-speed internet via cable/DSL in home
This is a non-exempt/hourly paid role. Must be willing to work core business hours of Mon-Fri, 8:00am - 5:00pm (CT) and overtime, when required at the request of the business
Expect to travel up to 10%25 of time in the field, visiting our members in their homes, long term care (LTC), or other approved facilities
Live within a 60 mile commutable driving distance to a TX UHG office

Nice To Haves

BSN - Bachelor of Science in Nursing
4+ years diversified clinical nursing experience, including medical/surgical nursing, case management or home care
Pediatric experience
Behavioral health experience
Field based work experience
Experience with electronic charting
Experience collaborating with communities of all different ethnicities, cultural backgrounds, diverse populations and/or underserved communities
Experience with arranging community resources
Background in managing populations with complex medical or behavioral needs
Background in managing populations with diabetes
Demonstrated knowledge of Medicaid, TX STAR Kids, STAR, CHIP
Proficiency in CMS marketing rules and regulations
Bilingual
Solid, interpersonal, relationship-building skills
Able to communicate effectively written and verbal in a professional manner
Ability to work in a self-directed manner within a fast-paced, deadline-driven environment
Proactively seeks guidance on complex tasks, as needed
Client focus and ability to adapt style and approach to customer preferences
Problem resolution and time management skills
Remain flexible, adaptable, and patient in all types of situations
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Responsibilities

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least 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
Understand role and how it affects utilization management benchmarks and quality outcomes

Benefits

Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

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