About the position

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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Efforts focused on medical, behavioral, and social determinants of health factors that improve the well-being of individuals, families, and communities. If you are located in Philadelphia, PA, you’ll enjoy the flexibility to work remotely as you take on some tough challenges. 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.

Responsibilities

• Engage members either face to face in the community setting or telephonically
• Conduct comprehensive member assessment that includes bio-psychosocial, functional, and behavioral health needs
• Utilize motivational interviewing techniques to help member identify and understand their intrinsic goals and motivate members to engage in positive behavior change
• Utilize active listening to collect and retain member information and incorporating responses as they are presented to complete assessment
• Engage member to participate in the assessment process and collaboratively develop plan of care based on their individual needs, preferences, and objectives
• Identify urgent member situations and escalate to next level when necessary
• Work with members to develop healthcare goals and identify potential barriers to achieving healthcare goals
• Educate members on health and wellness information related to assist with self-management
• Collaborate with member to create solutions to overcome barriers to achieving healthcare goals
• Identify relevant community resources available based on member needs
• Present complex case information to interdisciplinary care team and obtain input into member plans as necessary
• Use desk top computer applications (e.g., Excel, Word, Outlook, Office Communicator) to summarize information (e.g., reports) or communicate member information to others
• Document information (e.g., assessment information, member interactions, referrals, follow up plans) in relevant computer systems
• Learn updates and changes to computer systems/applications and apply to navigate applications effectively
• Execute and meet performance goals within a virtual environment

Requirements

• Bachelor’s degree or an Associate degree with RN license
• Unrestricted licensure as a Registered Nurse in the state of PA
• 4+ years Case Management and/or Care Coordination experience
• Background in managing populations with complex medical or behavioral health needs
• Ability to prove technical knowledge of Microsoft products including Excel and Outlook; ability to learn clinical applications quickly
• Must have a designated workspace and access to secure high-speed internet via cable/DSL in home
• Current driver’s license, auto insurance, and ability to travel on occasional field visits to members/hospitals
• Live in the Philadelphia, PA region

Nice-to-haves

• Certified Case Manager (CCM)
• A background in Managed Care
• Bilingual
• Experience in utilization review, concurrent review and/or risk management
• Solid desire and passion to help and work with members with complex medical, behavioral, or social needs
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Benefits

• 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).