UnitedHealth Group
Chattanooga or Manchester or McMinnville or Spencer or Altamont

Licensed Field Care Coordinator - Middle TN

$60,320 - $108,160/yrPosted today

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Job details

Location
Chattanooga or Manchester or McMinnville or Spencer or Altamont
Compensation
$60,320 - $108,160/yr
Posted
today
Apply on
uhg.taleo.net

About this role

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.

The primary purpose of this position is the application of clinical knowledge to coordinate member care needs for assigned members who are primarily medically complex and require intensive medical and psychosocial support.  The Care Coordinator works directly with members to ensure appropriate access to services and providers. Coordination of member care needs across the continuum begins with early identification of health risk factors, education, and prevention using the six essential activities of case management as per CMSA.  Coordination also assures the provision of appropriate services in acute, home, chronic and alternative care settings, to meet member needs in the most cost-effective manner available. Collaborates with all members of the Care Coordination team including Case Management, Utilization Review and Behavioral Health team members.

If you are located in or within commutable driving distance to Coffee, Franklin, Van Buren, Warren or Grundy Counties, you’ll enjoy the flexibility to work telecommute * as you take on some tough challenges. This is a field-based role.

Primary Responsibilities:

  • Application of clinical knowledge to effect efficient case management for those accessing their Medicare/Medicaid benefits
  • Incorporates evidence-based clinical practices into care coordination activities
  • Delivers member-centered, individualized self-management support and patient education
  • Installs appropriate equipment or supplies as needed and educates member on safe and effective use
  • Facilitates and participates in group visit strategies as defined by site, member and/or provider needs
  • Ensure appropriate utilization and consistent application of the health benefits
  • Conduct telephonic and face to face assessments according to Health Plan policy and procedure, including CommunityCare System documentation and State prescribed timeframes
  • Serve as member advocate and facilitator to resolve issues that may be perceived as barriers to care
  • Provide education and coordination of community resource referrals to members and providers
  • Develop, implement, maintain and evaluate a member centered, individual care plan when services are indicated, based on member care needs identified through proactive collaboration and communication with members, families and providers
  • Collaborate and communicate with other members of the Care Coordination Team to improve the quality and efficiency of health care delivery and assure smooth transition of care coordination activities to other team members
  • Coordinates care with UnitedHealthcare Inpatient Care Manager when member becomes hospitalized or seeks Emergency Room Services
  • Monitor hospital encounters of assigned members and provide education and/or interventions as necessary to reduce frequency
  • Refer clinical decisions beyond level of authority for members who do not meet established criteria to manager and/or Team Leader for review and decision
  • Participate in the Health Plan Quality Improvement process including recognition of quality-of-care issues and forward information to appropriate staff for review and resolution
  • Utilize Health Plan software to enter service requests, document, and monitor all aspects of patient care coordination and service delivery
  • Maintain time sensitive documentation to assure compliance with regulatory agencies
  • Coordinate services for members following Health plan policy
  • Perform other duties as assigned

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. 


%3Cp style=%22-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cstrong%3ERequired Qualifications:%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul style=%22-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger 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years of experience with MS Office, including Word, Excel, and Outlook%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExcellent organization, communication and time management skills%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EValid driver’s license, access to reliable transportation and the ability to travel up to 75% within an assigned territory to meet with members and providers%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EReside in or within a 50-mile radius commutable driving distance to Coffee, Franklin, Van Buren, Warren or Grundy Counties%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cstrong%3EPreferred Qualifications:%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul style=%22-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:12px 0px;orphans:2;padding:revert;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EBSN, Master%27s Degree or Higher in Clinical Field%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3ECCM certification%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E1+ years of community case management experience coordinating care for individuals with complex needs%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3ELong term care experience%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience working in team-based care%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EWorking knowledge of Medicare/Medicaid regulations%3C/span%3E%3C/li%3E%3Cli style=%22line-height:1.25;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EWorking knowledge of medical terminology%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0in 0in 9pt;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.%3Cu1:p%3E%3C/u1:p%3E%3C/span%3E%3C/p%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, 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!important;font-weight:400;letter-spacing:normal;line-height:20.7px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;%22 data-contrast=%22auto%22 xml:lang=%22EN-US%22 lang=%22EN-US%22%3EPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). 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We comply with all minimum wage laws as applicable.%3C/span%3E%3C/span%3E%3Cspan style=%22background-color:rgb(255,255,255);color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cspan class=%22EOP SCXO113953523 BCX0%22 style=%22-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;line-height:20.7px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;%22%3E%26nbsp;%3C/span%3E%3C/span%3E%3C/p%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0in 0in 9pt;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%26nbsp; %26nbsp;%26nbsp;%3Cu1:p%3E%3C/u1:p%3E%3C/span%3E%3C/p%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0in 0in 9pt;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3EAt UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.%3Cu1:p%3E%3C/u1:p%3E%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0in 0in 9pt;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cu1:p%3E%3C/u1:p%3E%26nbsp; %26nbsp;%26nbsp;%3C/span%3E%3C/p%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0in 0in 9pt;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%26nbsp; %26nbsp;%26nbsp;%3Cu1:p%3E%3C/u1:p%3E%3C/span%3E%3C/p%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0in 0in 9pt;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3EUnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0in 0in 9pt;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3E%26nbsp; %26nbsp;%26nbsp;%3Cu1:p%3E%3C/u1:p%3E%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0in 0in 9pt;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3E%3Cu1:p%3E%3C/u1:p%3EUnitedHealth Group%26nbsp;is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0in 0in 9pt;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3E%26nbsp; %26nbsp;%26nbsp;%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0in 0in 9pt;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3E%26nbsp; %26nbsp;%3Cu1:p%3E%3C/u1:p%3E%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:white;color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0in 0in 9pt;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cspan style=%22color:black;font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cu1:p%3E%3C/u1:p%3E%3Cu1:p%3E%3C/u1:p%3E#RPO #RED%3C/span%3E%3C/p%3E

Job Details
Job: Health & Social Services
Primary Location: US-TN-Chattanooga
Other Locations: US-TN-Manchester, US-TN-McMinnville, US-TN-Spencer, US-TN-Altamont
Organization: C&S Tennessee ABD LTC
Schedule: Full-time
Number of Openings: 1
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About UnitedHealth Group

UnitedHealth Group
Chattanooga or Manchester or McMinnville or Spencer or Altamont