Telephonic Case Manager - Remote in Michigan

UnitedHealth Group•Southfield, MI

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. In this Telephonic Case Manager role, you 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 are located within the state of Michigan, you will have the flexibility to be 100%25 telecommute as you take on some tough challenges.

Requirements

Unrestricted RN license or LMSW in the State of Michigan
4+ years of experience working within the community health setting in a health care role/clinical health care role
1+ years of experience working with MS Word, Excel and Outlook
1+ year of community mental health experience OR 1+ year of experience working with individuals with severe mental health conditions

Nice To Haves

Case Management experience including Certification in Case Management
Background in managing populations with complex medical or behavioral needs
Telephonic Case Management experience
Experience with electronic charting
Experience with arranging community resources
Experience in Utilization Management, Home Health and/ or Discharge Planning
Medicaid, Medicare, Managed Care experience
Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
Experience using multiple systems to retrieve member data
Problem solving experience; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
Experience in long-term care, home health, hospice, public health or assisted living

Responsibilities

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care
Manage the care plan throughout the continuum of care as a single point of contact
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 health care team
Provide telephonic care management to members on caseload including specialized populations such as the Justice Involved population
Support Care Management efforts to outreach members recently discharged from the hospital to determine needs and prevent avoidable readmissions
Work with Pharmacy Lock-in members, which includes Care Management support, pharmacy change requests, and periodic determination of ongoing member eligibility for the program
Present and participate in Interdisciplinary rounds
Collaborate with Medical Directors regarding member needs and complex issues
Support Quality and Population Health initiatives as requested
Participate in work groups to assist with processes and workflows