In your field, learning never stops. And neither do you. You are continually pushing yourself to reach higher and go further. To do everything you can to ensure a positive outcome for our patients. Staying on top of your game and persevering in the face of challenge will be a big part of your success. And at every turn, you'll have the support of an elite and dynamic team. Join us in this role and you will use your diverse knowledge and experience to make health care work better for our patients, while doing your life's best work.(sm) As a Care Coordinator working with our NM Centennial Care members, you will be providing a vital service to our members through care coordination activities including conducting assessments, care planning, telephonic and in-home visits, coordination of benefits and services, and linking members to community-based resources. This is a field based / telecommuting role that requires 80% travel throughout surrounding areas. Primary Responsibilities: Complete initial and routine assessments for the purpose of identifying member care needs Initiate care planning and implementation of a comprehensive care plan which is member-driven and addresses medical and/or behavioral health needs Engage members routinely telephonically and in-person via home / facility visits to coordinate services, community resources, and provide health education Provide education and information on available benefits and services and how to access appropriate care Identify early risk factors and targeted condition management interventions as necessary Create, review and revise Care Plans with a focus on health education and improving health outcomes Advocate for member needs and services and provide assistance to members in navigating the healthcare system Focus on reducing hospital admissions through coordinated care and effective discharge planning with other team members Collaborate with the member's PCP and other care team members to deliver and coordinate quality care and services Build and maintain relationships with members and their representatives to empower personal responsibility and decision making on healthcare matters Ensure completion of required touch points and care coordination activities and document all activities within the member clinical record Participate in interdisciplinary case reviews or co-managed cases to ensure an effective and comprehensive approach to engage members Promote condition management and principles of recovery and resiliency Attend routine team meetings and offer creative solutions and innovative approaches to further enhance the clinical model
Required Qualifications: Bachelor's degree or higher in Social Work or a healthcare related field with a 1+ year of clinical or case management experience in a medical, long-term care or behavioral healthcare setting OR Associates degree or higher in Nursing with current, unrestricted RN licensure in the state of New Mexico and 1+ year of clinical or case management experience in a medical, long-term care or behavioral healthcare setting Proficiency using a PC in a Windows environment, including Microsoft Word, Excel, Outlook, Internet and Clinical Databases Willingness to travel within a designated geographical region of New Mexico for home / site visitsAccess to reliable transportation that will enable you to travel to client and / or patient sites within a designated areaPreferred Qualifications: Medicare / Medicaid experience A background working with complex medical, long-term care and / or behavioral health populations Experience with electronic documentation methods and field-based technology use Bilingual in English / Spanish 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) 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: RN, Registered Nurse, Case Manager, CCM, Social Worker, Care Coordinator, Service Coordinator, Cuba, Santa Fe, Espanola, Los Alamos, Rio Arriba, NM, New Mexico
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.