Clinical Coordinator RN

3 weeks ago

Jacksonville, Texas, United States UnitedHealth Group Inc Full time
Field Clinical Coordinator RN Job Description

UnitedHealth Group Inc is seeking a skilled Field Clinical Coordinator RN to join our team. As a Field Clinical Coordinator RN, you will play a critical role in assessing, planning, and implementing care strategies for our members. You will work closely with patients, families, and healthcare providers to develop individualized plans of care that promote the most appropriate and least restrictive level of care.

Key Responsibilities:

  • Assess and plan care strategies for members, utilizing company and community-based resources to establish safe and effective case management plans.
  • Collaborate with patients, families, and healthcare providers to develop individualized plans of care that meet the unique needs of each member.
  • Identify and initiate referrals for social service programs, including financial, psychosocial, community, and state supportive services.
  • Manage care plans throughout the continuum of care, serving as a single point of contact for members and their families.
  • Communicate with stakeholders to ensure quality coordinated care and services are provided expeditiously to all members.
  • Advocate for patients and families as needed to ensure their needs and choices are fully represented and supported by the healthcare team.
  • Utilize approved clinical criteria to assess and determine the appropriate level of care for members.
  • Document all member assessments, care plans, and referrals provided.
  • Participate in interdisciplinary team meetings and utilization management rounds to provide information and support safe transitions of care.
  • Understand insurance products, benefits, coverage limitations, insurance, and governmental regulations as they apply to the health plan.
  • Accountable for understanding role and how it affects utilization management benchmarks and quality outcomes.

Requirements:

  • Current unrestricted RN license in the state of Texas.
  • 2+ years of experience working within the community health setting or in a healthcare role.
  • Familiarity with Microsoft Office, including Word, Excel, and Outlook.
  • Reliable transportation and the ability to travel in the assigned region to visit Medicaid members in their homes and/or other settings.
  • High-speed internet at residence.

Preferred Qualifications:

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

About UnitedHealth Group Inc:

At UnitedHealth Group Inc, 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. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.

Equal Employment Opportunity:

UnitedHealth Group Inc 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.

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