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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together
As a Field-Based Case Manager (CM), you will act in a liaison role to ensure appropriate care is accessed, as well as to provide home and social assessments and member education. Case Managers work in a team based structure and spend the majority of their time in the community engaging directly with members.
If you reside within a commutable distance of Pickaway, Fairfield, Ross, Fayette or Madison Counties, OH, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
- Engage members either face to face or over the phone to assist with closing gaps in care, linking to necessary services and providing education about their health
- Review available member service records and relevant documentation (e.g. utilization history, functional level, stratification information, current plan of care)
- Conduct member health assessment that includes bio-psychosocial, functional, and behavioral health needs
- Utilize interviewing techniques and active listening to collect and retain member information and incorporating responses as they are presented to complete assessment
- Identify member service needs related to health concerns
- Identify urgent member situations
- Engage member to participation in the assessment process and collaboratively develop Care Plan based on individual needs, preferences, and objectives
- Provide nursing oversight while collaborating with Care Guides (CGs)
- Work with members to develop healthcare goals and identify potential barriers to achieving healthcare goals
- Identify member support systems available and incorporate into their Care Plan
- Review plan benefits and identify appropriate programs and services based on health needs and benefits
- Integrate health care and services needs into a plan or recommendation for member care and service
- Work collaboratively with the interdisciplinary care team to ensure an integrated tam approach
- Collaborate with member to create solutions to overcome barriers to achieving healthcare goals
- Identify relevant community resources available based on member needs
- Refer members to appropriate programs and services
- Facilitate member choice of preferred provider
- Advocate for individuals and communities within the health and social service systems
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.
Required Qualifications:
- State of Ohio RN License, and applicable degree
- Field-based experience
- Knowledge of culture and values of community
- Familiarity with the resources available in the community
- Resided within the local community for 2+ years
- Reside or be able to commute within Jefferson County, Ohio
- Ability to travel locally up to 75% of the time
- Access to reliable transportation that will enable you to travel to member and/or patient sites within a designated area
- Available to work Monday through Friday 8:00 AM to 5:00 PM
- Have a dedicated work area established that is separated from other living areas and provides information privacy
- Proven ability to keep all company sensitive documents secure
- Live in a location that can receive UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Preferred Qualifications:
- Case Management Certification (CCM)
- Care management experience
- Experience working in Managed Care
- Telephonic customer service experience
- Knowledge of Medicaid and/or Medicare population
- Knowledge and/or experience with behavioral health or substance use disorders
- Employment in a medical office or other provider environment
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
#UHCPJ
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves 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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
