Clinical Case Coordinator
2 days ago
We're seeking a highly skilled Clinical Case Coordinator to join our team at UnitedHealth Group Inc in Jacksonville or Miami, FL. As a key member of our team, you'll be responsible for coordinating the healthcare needs of complex pediatric populations, ensuring seamless care transitions and improved health outcomes. With a focus on care coordination and case management, you'll work closely with patients, families, and healthcare providers to develop and implement comprehensive care plans.
Job Description:
- Key Responsibilities:
- Coordinate the healthcare needs of complex pediatric populations, providing personalized care coordination and case management services.
- Develop and implement comprehensive care plans that address medical, behavioral, functional, cultural, socioeconomic, and social determinants of health needs.
- Collaborate with internal care teams, providers, and community resources to leverage expertise and implement care plans.
- Monitor and update care plans, incorporating feedback from members to ensure compliance with interventions and achieve care plan goals.
- Provide education and coaching to support member self-management of care needs, lifestyle changes, and personal wellness planning.
- Assist members in developing health crisis plans and provide targeted activities to support HEDIS/STAR gap closure.
- Reassess and update care plans with changes in condition or care needs.
- Support proactive discharge planning and manage/cordinate care transitions following ER visits, inpatient or Skilled Nursing Facility (SNF) admissions.
- Access and coordinate Medicaid benefits to support care needs.
Requirements:
- Qualifications:
- Current, unrestricted independent licensure as a Registered Nurse (RN).
- 4+ years of relevant clinical work experience, including 3+ years of experience managing complex populations (e.g., Medicare, Medicaid).
- 3+ years of clinical pediatric experience and 1+ year of community case management experience coordinating care for individuals with complex needs.
- Reside in the state of Florida.
Salary: $95,000 - $110,000 per annum, depending on experience.
Benefits: Comprehensive benefits package, including medical, dental, and vision insurance, retirement savings plan, paid time off, and opportunities for professional growth and development.
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