HSS Clinical Coordinator RN

About the Role

At United Healthcare, 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.

• Serve as primary care manager for members with primary complex medical needs
• Engage members through a variety of modalities (face and/or telephonically) to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, socioeconomic and social determinants of health needs
• 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
• Partner and collaborate with internal care team, providers, community resources/partners and leverage expertise to implement care plan
• Monitor and update care plan, incorporating feedback from member to monitor compliance with interventions to achieve care plan goals
• Provide education and coaching to support
  • Member self‑management of care needs in alignment with evidence‑based guidelines
  • Lifestyle changes to promote health, i.e. smoking cessation, weight management, exercise
• Assist member in development of personal wellness plan / health crisis plan
• Perform targeted activities and provide education to support HEDIS/STAR gap closure, including scheduling, reminding and verification of appointment to receive specific services
• Monitor compliance with medication regimen and make referrals to Pharmacist for medication review and recommendations
• Reassess and update care plan with change in condition or care needs
• Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission
• Access and coordinate Medicaid benefits to support care needs
• Document all care management/coordination activity in clinical care management record

Schedule is Monday through Friday between the hours of 8 am to 5 pm.

Location will vary but within the following counties of Florida:
Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, Union, Hardee, Highlands, Hillsborough, Manatee, Polk.

Preference for those residing in the following counties:
Alachua, Clay, Duval, Flager, Nassau, St Johns, Volusia.

Local travel up to 10% and mileage is reimbursed at current government rate.

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life & AD&D Insurance along with Short‑term disability and Long‑Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

• Current, unrestricted, independent licensure as a Registered Nurse for state of Florida
• 4+ years of relevant clinical work experience
• 3+ years of experience managing needs of complex populations (e.g. Medicare, Medicaid)
• 1+ year of community case management experience coordinating care for individuals with complex needs
• Intermediate level of knowledge of Medicare and Medicaid benefits
• Ability to travel 10% of the time for role
• Access to a designated quiet workspace in your home (separated from non‑workspace areas) with the ability to secure Protected Health Information and live in a location that can receive a United Health Group approved high‑speed internet connection or leverage an existing high‑speed internet service
• Reside in the state of Florida

• Master's degree in nursing or related clinical field
• Experience…