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. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. This is the place to do your life's best work.(sm)In this role as a Field Care Coordinator you will work in the field and coordinate care on behalf of Medicaid patients who are receiving long-term care (LTC), along with home and community services. Your experience with hospital and long-term care facilities will be essential in relaying the pertinent information about the patient needs and advocating for the best possible care available. At times, your patience may be challenged. But in the end, your confidence, decisiveness and perseverance will help you positively impact our patient lives, and ensure more positive outcomes for all.What makes your clinical career greater with UHC? 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. JOIN US! APPLY NOW If you are located in St. Augustine, Palm Coast, Green Cove Springs, Flagler County or Clay County, Florida, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities:Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease 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 Manage 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 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 Accountable to understand role and how it affects utilization management benchmarks and quality outcomesThis is a field-based role with a home-based (telecommute, work at home) office. Candidates must be willing to travel up to 75% of the time.
Required Qualifications: Master's Degree in Social Work, Sociology, Psychology, Gerontology or a related social services field 1 years of clinical or case management experience 1 year of experience in long-term care, home health, hospice, public health or assisted living Computer / typing proficiency to enter / retrieve data in electronic clinical records; experience with email, Internet research, use of online calendars and other software applicationsPreferred Qualifications:Medicare, Medicaid or Medicaid Waiver experience Case management experience Bilingual skills in Spanish A background working in geriatric special needs A background in behavioral healthIf the hired individual resides in Florida (office based or telecommuting) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years. 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) *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. 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, Psychology, Sociology, Masters, MSW, LISW, LCSW, Licensed, Care Coordinator, Case Management, Medicaid, Managed Care, Behavioral Health, Mental Health, Home Health, Hospice, Public Health, Telecommuter, Telecommute, Telecommuting, Remote, Flagler County, Clay County, St. Augustine, Palm Coast, Green Cove Springs, FL, Florida, UHG, UnitedHealth Group, UHC, UnitedHealthcare, Community and State, Public Sector
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.