Regional Transition Care Manager -Tidewater

About the role

As part of a care management team who will manage complex members, the Regional Transition Coordinator will be the primary care manager for a panel of members with complex behavioral health needs (i.e., mental health or substance use disorders). Additionally, this position will provide behavioral health support to the broader team. Care coordination activities will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. This is a field-based position with a home-based office that will travel throughout the Tidewater Region. Expected travel approximately 50% of the time in Tidewater Region.

Responsibilities

• Participate in discharge planning for Members transitioning from LTC facility settings to the community
• Coordinate with Utilization Management staff, as indicated regarding discharge planning
• Collaborate and Coordinate with Nursing Facility staff, the Member's assigned care coordinator, and the Member when it is identified that the Member wishes to transition from NF care to the community
• Provide support to care coordinators to maintain Members in the community in lieu of transitioning to institutional settings, as needed
• Collaborate and partner with community resources (e.g. CILs, CSBs, AAAs, etc.) and work with staff to facilitate safe transitions for members willing and able to transition from custodial NF care back to a community setting of their choice
• Provide consistent follow up during the first year after discharge and shall make adjustments to the transition plan to assure acclimation and integration into the community as needed by the Member
• For Dual eligible members enrolled in a DSNP, the Regional Transition Coordinator shall also work with the DSNP care coordinator upon approval of the Member, to coordinate the above activities
• Review daily census, prioritizes daily work and monitor progress of transitions in accordance with Care Coordination policies
• Actively collaborate and communicate with physicians and providers to arrange appropriate follow up, discharge planning and/or alternative care and services for plan members
• Coordinate the authorization process for discharge planning needs in accordance with Plan policy and procedure
• Participate in NF ICT/ Care Team meetings as appropriate; NF Rounds, Quarterly team meetings with NF CC and other meetings as required to facilitate transitions
• Coordinate transition of members to other Level Care Coordinators as indicated
• Perform other delegated duties as assigned

Required Qualifications

Must meet one of the following:

• Bachelor's degree in a health or human services (e.g., psychology, counseling, etc.)
• LPN
• 1+ years of experience with local behavioral health providers and community support organizations addressing SDoH (e.g., food banks, non-emergent transportation, utility assistance, housing / rapid re-housing assistance, etc.)
• 1+ years of experience with MS Office, including Word, Excel, and Outlook

Preferred Qualifications

• RN, LMCSW, LBSW, QMHP
• Demonstrated experience / additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care
• Experience working in team-based care
• Experience in serving individuals with co-occurring disorders (both mental health and substance use disorders)
• Background in Managed Care
• Bilingual in Spanish or other language specific to market populations

Pay

The hourly pay for this role will range from $24.00 to $43.00 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

All benefits are subject to eligibility requirements.

Schedule & Travel

Field-based position with a home-based office. Travel throughout the Tidewater Region approximately 50% of the time.

Telecommuter Policy

All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.