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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.
Positions in this function address efforts focused on improving the clinical, behavioral and social determinants in the management of chronic conditions in members enrolled in the Comprehensive Long Term Care program. In this Health and Social Services Clinical Case Manager role, you will be an essential element of an Integrated Care Model by identifying potentials gaps in the management and/or education of various conditions such as cancer, diabetes, asthma, hypertension, behavioral health, and other special health care needs.
This is a Telecommuter full-time position with 25 - 50% of time spent in the field (once appropriate to do home visits again) in the Miami area and surrounding counties.
If you are located within a commutable distance from Miami, FL, you will have the flexibility to telecommute* as you take on some tough challenges. Please note that this is a work from home opportunity, but you need to live in or near the posted area.
- Act as a subject matter expert and clinical resource for members related to the health plan’s special needs populations (Clinical issues, available health plan and community resources)
- Electronic Documentation for individualized members, coordination of referrals, and assistance with needed resources
- Complete individualized assessments via telephone and/or face to face with members based on disease and condition and create customized and individualized treatment care plans
- Educate members on disease state as recommended in clinical practice guidelines
- Assist members to navigate the health care system and refer members to community resources when appropriate
- Ensure continuity of care is maintained and Identify gaps in care
- Link eligible enrollees with healthcare, behavioral health, substance abuse program and other services in a timely manner
You’ll 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.
- Active - Unrestricted LPN License in the state of Florida
- 2+ years of experience in Disease Management
- Intermediate proficiency working with MS Office Products (Word, Excel, Power Point and Outlook), as well as proficiency in various Electronic Patient Documentation systems
- Ability to travel in assigned region to visit Medicaid members in their homes and/or other settings, including community centers, hospitals or providers' offices
- Bilingual in Spanish
- You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role
- Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
- Case management and/or care coordination experience
- 1+ years of Managed Care experience
- Background in managing populations with complex medical or behavioral needs
- Experience with coordinating community resources
- Field based work experience
- Experience and familiarity with Medicaid benefits
- Experience utilizing interpreter language line
If the hired individual resides in Florida (office based or telecommuting) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years.
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.
Job Keywords: Case Manager, LPN, LVN, Nurse, Nurse Case Manager, Clinical, Case Management, Care Manager, Disease Management, Disease Manager, Medicare, Medicaid, Medicaid Waiver, MDS, Managed Care, Behavioral Health, Mental Health, Community Health, Long Term Care, LTC, Hospice, Public Health, Assisted Living , United Healthcare, UHC, Field Based, Telecommute, Telecommuter, Telecommuting, Work From Home, Remote, Miami, FL, Florida