HSS Clinical Coordinator, RN - Remote in Texas

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.

In this Field Care Coordinator RN role, will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs.

If you reside in Texas, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease 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
• Accountable to understand role and how it affects utilization management benchmarks and quality outcomes
• You'll need to be flexible, adaptable and, above all, patient in all types of situations

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 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

Preferred Qualifications:

• 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

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.