Durham, North Carolina, North Carolina
West Roxbury, Massachusetts, Massachusetts
Linthicum Heights, Maryland
Posted: 19-Dec-24
Location: Metairie, Louisiana
Categories:
Internal Number: 145286949
At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
The Care Coordinator, as a part of the primary care patient centered medical home team, engages in a collaborative process, which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet a member’s health needs through communication and available resources to promote quality, cost effective outcomes. The Care Coordinator is responsible for ensuring a member’s encounter with providers, office staff, and Peoples Health is seamless and comprehensive. The Care Coordinator will review, plan, and coordinate health care services in order to utilize appropriate processes and appropriate resources to improve member’s health outcomes.
If you reside in the state of LA or have a compact license with the ability to practice in the state of LA, you will have the flexibility to work remotely* as you take on some tough challenges. Must be able to work Monday through Friday 8am-5pm CST.
Primary Responsibilities:
- Provides patient-centered interventions, such as performing medication and care compliance initiatives, case management, etc.
- Assesses the total individual, inclusive of medical, psychosocial, behavioral, cultural and/or spiritual needs to develop a plan of care that promotes quality outcomes
- Interacts with the member and the multidisciplinary team to establish measurable health care goals and prioritization of the member’s needs. Monitors the member’s adherence to the plan of care
- Serves as health coach to educate the member, the family and/or caregiver, about disease status and treatment, plan benefits, community resources, and resource options
- Assists member with scheduling appointments with the primary care provider (PCP), specialists’, referrals, follow-up testing and/or office procedures
- Monitors performance against assigned member’s gaps in HEDIS and Star measures through weekly report analysis and ensures receipt, review and documentation of test and treatment results
- Identifies, plans and documents all follow up to hospital treatment with the interdisciplinary team and primary care physician (PCP)
- Collaborates in efforts that focus upon moving the individual to self-care when possible
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- Licensed RN or compact RN license with the ability to practice in the State of Louisiana
- 2+ years of experience in a clinical setting
- 2+ years of experience with clinical documentation systems
- 2+ years of experience in assessing members and developing care plans
- Proficient with MS Office (MS Word, Excel and PowerPoint)
- Ability to work Monday through Friday 8am-5pm Central Standard Time hours
Preferred Qualifications:
- Bachelor’s degree in Nursing
- Disease management, chronic care improvement and/or quality improvement experience in a managed care setting
- Case management or care coordination experience
- Experience in managed care industry setting - STAR/HEDIS experience
- Proven understanding of HMO and third-party administration
- Proven understanding of nursing home and long-term acute care regulations
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
At UnitedHealth Group, 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. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
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.
