For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) The Field Care Coordinator is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. May also be responsible for providing health education, coaching and treatment decision support for members. *This is a field-based position covering Kansas City Metro area, Wyandotte and Johnson Counties in Kansas* *Work schedule: Monday - Friday, 8am - 5pm, no weekends, on-call or holiday coverage* Primary Responsibilities:Primarily provides care coordination / case management for members who are eligible for Nursing Facility Level of Care / Waiver services in a community or facility setting and are at high risk for clinical complication and/or have complex care management / coordination needs Conducts face to face and telephonic member needs assessments according to state and national guidelines, policies, procedures, and protocols Determines member's overall bio-psychosocial needs and develops individualized member service / care plan including long term care services and supports based on assessment data, member and caregiver / stakeholder input, and cost-effective options for service delivery Provides options and choices for long term care community or facility-based service delivery Develops member goals of care and interventions for unmet needs in coordination with the member Facilitates authorization, coordination, continuity and appropriateness of care and services in community or LTC setting Routinely and as needed evaluates the effectiveness of the care / service plan and makes appropriate revisions per policy & procedure / state contractual requirements Facilitates appropriate member referrals to special programs such as Disease/Chronic Condition Management, Behavioral Health, Advanced Illness, Complex Case Management Coordinates benefits through other available payment sources Assists the member to access community, Medicare, family and other third-party resources as appropriate Facilitates care setting transitions and access to special programs (e.g. Hospital to Home, Advanced Illness, transition from Nursing Facility to community setting) Collaborates and communicates with the member's health care and service delivery team to coordinate the care needs for the member Provides education to members regarding health care needs, available benefits and services Works to facilitate member compliance with their care / treatment plan and to ensure continuity of care Identifies barriers to optimal care and outcomes or clinical concerns and communicate with members and providers to formulate action plan to address Documents all care coordination activities and interventions in the member's health plan clinical record Maintains a focus on timely, high-quality customer service Maintains the confidentiality of all sensitive information
Required Qualifications:Bachelor's level degree in Social Work or higher OR RN licensure or temporary RN licensure with the ability to obtain a permanent license within 30 days of employment in the state of KS 2+ years clinical or case management experience in long-term care, home health, hospice, public health or assisted living (post graduate experience) Experience working with Intellectually Developmentally Disabled population (IDD) Computer / typing proficiency to enter / retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications (Word, Excel, Internet, Outlook)Preferred Qualifications: Master's degree in Social Work Medicare / Medicaid experience A background working in geriatric special needs Experience in Home & Community based or Long Term Care services delivery or Waiver ProgramA background in behavioral health Experience with electronic charting Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV / AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Social Worker, IDD, Intellectually Developmentally Disabled, home health, hospice, assisted living, public health, long-term care, Kansas City Metro, Wyandotte County, Johnson County, Overland Park, Kansas City, Kansas, KS, Managed Care, Medicare, Medicaid
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.