Regional Transition Coordinator – Remote

Requisition Number: 2302631
Job Category: Medical & Clinical Operations
Primary Location: Fredericksburg, VA, US
(Remote considered)

Doctor consulting nurse at nurse station.

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 part of a care management team who will manage complex members, the Regional Transition Coordinator will be the primary care manager for a panel of members with complex behavioral health needs (i.e., mental health or substance use disorders).  Additionally, this position will provide behavioral health support to the broader team. Care coordination activities will focus on supporting member’s medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care.

If you are in Northern Virginia, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • Participate in discharge planning for Members transitioning from LTC facility settings to the community
  • Coordinate with Utilization Management staff, as indicated regarding discharge planning
  • Collaborate and Coordinate with Nursing Facility staff, the Member’s assigned care coordinator, and the Member when it is identified that the Member wishes to transition from NF care to the community
  • Provide support to care coordinators to maintain Members in the community in lieu of transitioning to institutional settings, as needed
  • Collaborate and partner with community resources (e.g. CILs, CSBs, AAAs, etc.) and work with staff to facilitate safe transitions for members willing and able to transition from custodial NF care back to a community setting of their choice
  • Provide consistent follow up during the first year after discharge and shall make adjustments to the transition plan to assure acclimation and integration into the community as needed by the Member
  • For Dual eligible members enrolled in a DSNP, the Regional Transition Coordinator shall also work with the DSNP care coordinator upon approval of the Member, to coordinate the above activities
  • Review daily census, prioritizes daily work and monitor progress of transitions in accordance with Care Coordination policies 
  • Actively collaborate and communicate with physicians and providers to arrange appropriate follow up, discharge planning and/or alternative care and services for plan members 
  • Coordinate the authorization process for discharge planning needs in accordance with Plan policy and procedure 
  • Participate in NF ICT/ Care Team meetings as appropriate; NF Rounds, Quarterly team meetings with NF CC and other meetings as required to facilitate transitions
  • Coordinate transition of members to other Level Care Coordinators as indicated 
  • Perform other delegated duties as assigned

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:

  • Must meet one of the following:
    • 4+ years or Higher Degree in a behavioral health related field (e.g., psychology, counseling, etc.) and 3+ of direct experience
    • LPN with 3+ years of direct experience
  • 2+ years of directly serving individuals with behavioral health conditions (mental health / substance use disorders)
  • 1+ years of experience with local behavioral health providers and community support organizations addressing SDoH (e.g., food banks, non-emergent transportation, utility assistance, housing / rapid re-housing assistance, etc.)
  • 1+ years of experience with MS Office, including Word, Excel, and Outlook

Preferred Qualifications:

  • Demonstrated experience / additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care
  • Experience working in team-based care
  • Experience in serving individuals with co-occurring disorders (both mental health and substance use disorders)
  • Background in Managed Care
  • Bilingual in Spanish or other language specific to market populations

*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 $23.41 to $41.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

Additional Job Detail Information

Requisition Number 2302631

Business Segment UnitedHealthcare

Employee Status Regular

Job Level Individual Contributor

Travel No

Country: US

Overtime Status Non-exempt

Schedule Full-time

Shift Day Job

Telecommuter Position Yes

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