Field Based RN Care Coordinator – Reston, VA and surrounding areas

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.

 

If you reside within a commutable distance of Northern Virginia, you’ll enjoy the flexibility to work remotely * as you take on some tough challenges. 

 

Primary Responsibilities:

• Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic 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, and community resources/partners to implement care plan
• Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health
• Advocate for members and families as needed to ensure the member’s needs and choices are fully represented and supported by the health care team
• Intake of provider, care coordinator, and Continuity of Care HCBS (home and community-based service) assisted technology and environmental modifications authorization requests
• Review and processing of all HCBS service authorization requests
• Engagement with providers and initiation/follow-up on requests for information
• Engagement with the National Letters Team to complete mailing of member and provider notification of decision
• Consistent application of criteria for review and approval of provider authorization requests
• Engagement/follow-up with Medical Director to provide clinical information needed for review and application of clinical criteria
• Engagement/follow-up with Care Coordinators for assessment of member care needs
• Candidate should be a patient advocate, and have tenacity for finding solutions
• Candidate should have extensive knowledge of the continuum of care
• Candidate should conduct themselves in a professional manner at all times

 

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:

• Unrestricted RN license in the state of Virginia
• RN with 4+ years of relevant work experience or 4-year degree.
• 4+ years of clinical experience
• Intermediate-Advanced proficiency experience with Microsoft Office Suite programs (Word, Excel, Outlook)

 

Preferred Qualifications:

• Previous experience in a work from home environment
• Direct experience working with HCBS authorizations and communicating with HCBS providers
• Broad knowledge of the Virginia Medicaid and/or CCC Plus program including coverage and benefits
• Utilization Management experience, including experience working with InterQual Criteria and/or Milliman Care guidelines
• Experience working with Community Care, Facets, and ICUE programs

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

The hourly range for this role is $28.61 to $56.06 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

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. 

 

 

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.