Clinical Coordinator, RN

About This Role

This remote Field Care Coordinator RN role at UnitedHealthcare involves assessing, planning, and implementing individualized care strategies. It focuses on relaying patient needs, advocating for optimal care, and ensuring access to appropriate services within an Integrated Care Model.

Responsibilities

• Assess, plan and implement care strategies individualized by patient and directed toward the most appropriate, least 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
• 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

Requirements

• Current RN unrestricted license in the State of TX or a compact RN license
• 2+ years of experience working within the community health setting or in a health care role
• 2+ years of experience working in community health, clinical, hospital, acute care, direct care or case management setting
• 2+ years of experience working with MS Word, Excel, and Outlook
• High-speed internet at residence
• Must live within a 60-mile commutable driving distance to a UHG office
• Reside in the state of Texas

Qualifications

• 2+ years of experience working within the community health setting or in a health care role; 2+ years of experience working in community health, clinical, hospital, acute care, direct care or case management setting

Nice to Have

• 1+ years of experience with long term care services and support, Medicaid, or Medicare
• Knowledge of the principles of most integrated settings, including federal and state requirements like the federal home and community-based settings regulations
• Proven ability to create, edit, save and send documents, spreadsheets and emails

Skills

* Required skills

Benefits