English

UnitedHealth Group•Seattle, WA

4h•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 on 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 want to achieve more in your mission of health care, you must be smart about the business of health care. As a Remote / Telephonic Case Manager – Bilingual Spanish / English, you will work with our Medicaid members primarily focusing on our Spanish speaking population, wearing many hats. Sometimes, you'll interact with members leaving the hospital - possibly with new medications or diagnoses. You may also act as an intermediary between providers and members - serving in numerous roles, such as educator, evaluator, service coordinator, community resource researcher and more. Resulting in fewer hospitalizations, ER visits and costly service gaps; and a less stressful, more effective health care system for us all, and all from your own home. What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

Requirements

Current, unrestricted WA state (or multi-state) RN license
2+ years of healthcare experience
1+ years of experience working with complex, high-risk, or chronic condition populations
Intermediate level of computer/typing proficiency to enter/retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications
Access to high-speed internet from home
Willing and able to work in the pacific time zone
Bilingual proficiency in English and Spanish (verbal and written)

Nice To Haves

Bachelor's degree
Certification in Case Management (CCM)
Case Management experience in a managed care, health plan, or value-based care environment
Minimum of 2–3 years of care management, case management, population health, or related experience
Medicaid Managed Care experience
Working knowledge of NCQA Population Health Management standards
Knowledge of community resources and social determinants of health
Prior remote or telephonic care management experience
Experience with vulnerable subpopulations include children and youth with special health care needs, adults with serious mental illness, members with substance use disorders and members with other complex or multiple chronic conditions
Strong telephonic engagement and motivational interviewing skills
WA State residence

Responsibilities

Deliver a complete continuum of high-quality care through proactive and ongoing communication with members in their preferred language via phone and virtual platforms
Assist members with safe and effective transitions from in-patient, skilled nursing, or other facility settings back to the home environment
Coordinate follow-up appointments, services, and equipment to reduce remissions and ensure continuity of care
Collaborate with interdisciplinary teams, providers, and facilities to support smooth transitions
Establish therapeutic relationships with members and caregivers to support engagement, adherence, and self-management
Conduct comprehensive, ongoing assessments to identify clinical, behavioral, and psychosocial needs
Provide a complete continuum of quality care through close communication with members via phone interaction
Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels
Assist members with the transition from a care facility back to their home
Meet NCQA Population Health Management Standards
Meet state-specific contractual requirements related to the delivery of care management
Provide member education on medications, disease management, and other healthcare related needs