HSS Clinical Coordinator RN - Florida

About the role

This position will be the primary care manager for a panel of members with primary complex medical needs. The Care Management / coordination activities will focus on supporting member's medical, behavioral and socioeconomic needs to promote appropriate utilization of services and improved quality of care.

Responsibilities

• Serve as primary care manager for members with primary complex medical needs
• Engage members through a variety of modalities (face and/or 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 goals
• 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
• 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

Requirements

• Current, unrestricted, independent licensure as a Registered Nurse for state of Florida
• 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
• Intermediate level of knowledge of Medicare and Medicaid benefits
• Ability to travel 10% of the time for role

Qualifications

• Master's degree in nursing or related clinical field
• Experience working with behavioral health issues that can be applied to help guide and support members with behavioral health needs
• Experience working in team-based care
• Bilingual in English/Spanish
• Experience working in Managed Care
• Lived experience (self or family) in managing or overcoming chronic health, behavioral health or substance use condition

Skills

• Possess a strong work ethic
• Listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner
• Adapt to change in the workplace
• Work independently and as a part of a team
• Interact with internal and external customers in a corporate environment
• Possess a positive and motivated attitude
• Willingness to adapt to multiple external environments and settings

Benefits

• Competitive base pay
• Full and comprehensive benefit program
• Performance rewards
• A management team who demonstrates their commitment to your success
• Some of our offerings include Paid Time Off, Medical Plan options, Dental, Vision, Life & AD&D Insurance, 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.)

Pay and Schedule

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).

The hourly pay for this role will range from $29.00 to $52.00 per hour based on full-time employment. This role is also eligible to receive bonuses based on sales performance.

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.

#RPO #GREEN