Serve as primary care manager for members with complex medical/behavioral needs. Engage members telephonically to complete a comprehensive needs assessment, including assessment of medical, functional, cultural and socioeconomic (SDOH) domains. 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 gui... more details
At UnitedHealthcare, were 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.
This is a 100% remote opportunity - Monday through Friday 8am - 5pm.
In this Behavioral Telephonic RN role, you 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 have NY RN licensure, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
- Serve as primary care manager for members with complex medical/behavioral needs
- Engage members telephonically to complete a comprehensive needs assessment, including assessment of medical, functional, cultural and socioeconomic (SDOH) domains
- 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
- Identify gaps or barriers in treatment plans
- Partner and collaborate with internal care team, providers, community resources/partners and leverage expertise to implement care plan
- Coordinate care for membersand services as needed (home health, DME, etc.)
- Provide education and coaching to support Member self-management of care needs in alignment with evidence-based guidelines; HEDIS/STAR gap closure
- Provide psycho-education regarding conditions, medications/ medication adherence, provider/ treatment options, healthcare system utilization
- Help identify presence or exacerbation of behavioral health symptoms that may be influencing / impacting physical health
- Provide guidance / consultation to other team members regarding physical/behavioral health conditions, best practice and evidence
Youll 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 NY RN license
- 3+ years of experience managing needs of complex populations (eg. Medicare, Medicaid)
- 2+ years of relevant clinical work experience
- 1+ years of community case management experience coordinating care for individuals with complex needs
- 1+ years of experience working directly with individuals suffering from behavioral health illnesses (depression, addiction, bi-polar)
- Applied knowledge of Medicare and Medicaid benefits
- Ability to navigate a Windows environment, utilize Outlook,and the ability to create, edit, save and send documents utilizing Microsoft Word
Preferred Qualifications:
- Bachelor's Degree
- Certified Case Manager (CCM)
- Demonstrated experience / additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care
- Experience working in managed care
*All employees working remotely will be required to adhere to UnitedHealth Groups Telecommuter Policy
New York Residents Only: The hourly range for New York residents is $28.03 to $54.95 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, youll find a far-reaching choice of benefits and incentives.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves 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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
