You push yourself to reach higher and go further. Because for you, it’s all about ensuring a positive outcome for patients. In this role, you’ll work in the field and coordinate the long-term care needs for patients in the local community. And at every turn, you’ll have the support of an elite and dynamic team. Join UnitedHealth Group and our family of businesses and you will use your diverse knowledge and experience to make health care work better for our patients.
In this Complex RN Clinical Coordinator role, you will manage complex members and be responsible for facilitating, promoting and advocating for the enrollees’ ongoing self-sufficiency and independence. This position is responsible for assessment and planning for an identified group of patients (Community Well/Emerging High Risk and the Vulnerable Sup populations). The RN Coordinator will manage the care of members in their homes or other community settings by completing telephonic an or face to face health risk assessments and coordinating patient care, focusing on disease management and keeping members healthy and independent. Provide clinical and medical management services, including care management, health assessments, interventions, and discharge planning. Work is generally self-directed and not prescribed; so it will be important to function in a less structured work environment.
If you are located in the Northern Virginia area, you will have the flexibility to telecommute* as you take on some tough challenges.
- Engaging members / families telephonically and or face to face to coordinate services, community resources and treatment needs
- Delivering a holistic approach to coordinated care based on the member’s needs using a person centered philosophy
- Identifying early risk factors and conducting ongoing assessments and documenting in an electronic file
- Creating, reviewing and revising care plans and focusing on a holistic approach
- Functioning as an advocate for member
- Collaborating with the member's PCP to deliver and coordinate necessary services
- Building relationships with members and their families; assisting them with coordination of health choices
- Ensuring cases are documented in a timely manner
- Coordination with other state agencies, community resources and providers
- Act as the primary point of contact for Members and the Interdisciplinary Care Team (ICT)
**This is a role will require 25% travel within an assigned coverage area in Northern, VA.**
• Current, unrestricted RN license for the state of Virginia
• 4+ years of experience working within the community health setting in a health care role
• At least 1 year experience directly working with individuals with complex medical or behavioral needs
• Experience in long-term care, home health, hospice, public health or assisted living
• Proficiency with MS Word, Excel and Outlook
• The ability to travel 25% of the time in assigned region to visit Medicaid members in their homes and/or other settings, including community centers, hospitals or providers' offices
• Pediatric experience - STRONGLY preferred
• Behavioral health or clinical degree
• Experience with Medicaid and/or Medicare
• Previous case management experience
• CCM certification
• Managed care experience
• Prior field based work experience
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work. (sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.
Keywords: Registered Nurse, Community Health, RN, Nurse, Case Manager, MLTSS, VAMLTSS, Medicaid Waiver, Behavioral Health, Public Health, Community Health, Long Term Care, Rehab, Home Care, Care Coordination, Home Health, Complex Case Management, Managed Care, Bilingual, Shenandoah County, Frederick County, Warren County, Page County, Clarke County, Woodstock, Winchester, Front Royal, Luray, Berryville, Washington, Warrenton, VA, Virginia, UHG, UnitedHealth Group, UHC, UnitedHealthcare, Community and State, Public Sector