Telephonic HSS Coordinator - Remote in the State of VA

About the role

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 optimized.

Responsibilities

• Facilitate, promote and advocate for enrollees' ongoing self-sufficiency and independence
• Assess and plan for an identified group of patients (Community Well/Emerging High-Risk Population)
• Manage the care of members in their homes or other community settings by completing telephonic health assessments and coordinating patient care
• Focus on disease management and keeping members healthy and independent
• Provide clinical and medical management services, including care management, health assessments, interventions, and discharge planning
• Identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD
• Engage members and families telephonically to coordinate services, community resources and treatment needs
• Deliver a holistic approach to coordinated care based on the member's needs using a person-centered philosophy
• Identify early risk factors and conduct ongoing assessments, documenting in an electronic file
• Create, review and revise care plans with a holistic approach
• Function as an advocate for members
• Collaborate with members' primary care providers to deliver and coordinate necessary services
• Build relationships with members and their families; assist them with coordination of health choices
• Ensure cases are documented in a timely manner
• Coordinate with other state agencies, community resources and providers
• Act as the primary point of contact for members and the Interdisciplinary Care Team

Requirements

• LPN or Bachelor's Degree in Social Work, Public Health or other related health fields
• 2+ years of experience in case management, long-term care, home health, hospice, public health, or assisted living
• 1+ years of experience directly working with individuals with complex medical or behavioral needs
• 1+ years of experience using Microsoft Word, Excel, Outlook and Internet
• Reside within the state of Virginia
• Access to reliable transportation and valid US driver's license

Preferred Qualifications

• Experience with Medicare and/or Medicaid
• Experience with complex populations
• Telephonic/Call Center experience
• Managed Care/Case Management experience