Position: HSS Clin Coordinator RN – Telecommute – Florida – Telemetry
HSS Clin Coordinator RN – Telecommute – Florida
At United Healthcare, 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.
As a Health and Social Services Clinical Coordinator working with Medicaid / Medicare members you’ll wear many hats, and work in a variety of environments. Sometimes, you’ll interact with members leaving the hospital – possibly with new medications or diagnoses. Or perhaps you’ll perform home visits, assisting members with safe, effective transitions from care environments to where they live. You may also act as an intermediary between providers and members – serving in numerous roles, such as educator, evaluator, service coordinator, community resource researcher and more.
The result? Fewer hospitalizations, ER visits and costly service gaps; and a less stressed, more effective health care system for us all. Want more flexibility, want more autonomy? Work from your own home and coordinate a visiting schedule that is mutually beneficial to you and the members we serve. If you reside within the state of Florida, you will have the flexibility to work in both the field as well as telecommute
as you take on some tough challenges.
Primary Responsibilities:
Serve as primary care manager for members with primary complex medical need
Engage members through a variety of modalities (telephonically) to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, socioeconomic and SDOH needs
Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines
Partner and collaborate with internal care team, providers, community resources/partners and leverage expertise to implement care plan
Monitor and update care plan, incorporating feedback from member to monitor compliance with interventions to achieve care plan goal
Provide education and coaching to support
Member self-management of care needs in alignment with evidence-based guidelines
Lifestyle changes to promote health, i.e. smoking cessation, weight management, exercise
Assist member in development of personal wellness plan / health crisis plan
Perform targeted activities and provide education to support HEDIS/STAR gap closure, including scheduling, reminding and verification of appointment to receive specific services
Monitor compliance with medication regimen and make referrals to Pharmacist for medication review and recommendations
Reassess and update care plan with change in condition or care needs
Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission
Access and Coordinate Medicaid Benefits to support care needs
Document all care management/coordination activity in clinical care management record
Performs all other duties as assigned What are the reasons to consider working for United Health Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
More information can be downloaded at: (Use the “Apply for this Job” box below). 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:
Current, unrestricted, independent licensure as a Registered Nurse
4+ years of relevant clinical work experience
3+ years of experience managing needs of complex populations (e.g. Medicare, Medicaid)
1+ years of community case management experience coordinating care for individuals with complex needs
Demonstrated knowledge of Medicare and Medicaid benefits
Reside in the state of Florida
Preferred Qualifications:
Bachelor’s Degree or greater
Certification in Case Management (CCM)