Field Based Care Manager RN or SW - Remote in Louisiana

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 and start doing your life's best work.(sm)

The HSS Clinical Coordinator- RN: Foster Care/Specialized Child & Youth Program operates within Community & State (Medicaid) line function and works with and interfaces with Medical Directors and other key stakeholders. External facing includes hospitals and other facilities, both contracted and non-contracted. In addition, this position will interface with Optum Behavioral Health.

This position is responsible for the children in the care and custody of the state managed by the health plan. This position is also responsible for serving as a liaison with state agencies, including and not limited to Department of Mental Health, Department of Developmental Resources, Office of Juvenile Justice, Department of Children and Family Services, Department of Elementary and Secondary Education, Medicaid Services, and consultation with the Health Plan about interaction and services to these departments. This position is responsible for clinical and thought leadership related to children and families who interact with the child welfare and juvenile justice systems through foster care, adoptive assistance, former foster youth (through age 26) and youth in the custody of the juvenile justice system.

You will report to the Health Services Director and/or Special Population Manager or designated Health Plan representative.

In this position, expect to spend approximately 25% of your time visiting our stakeholders, our members in their homes or in long-term care facilities. You'll need to be flexible, adaptable and, above all, patient in all types of situations.

If you are located in Louisiana, you will have the flexibility to work remotely* as you take on some tough challenges

Primary Responsibilities:

• Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care
• Identify, initiate, coordinate, and monitor referrals for psychosocial, behavioral, and medical services
• Manage the care plan throughout the continuum of care as a single point of contact
• Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
• Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team
• Provide trauma-informed and disease/disorder specific education to members and caregivers
• Coordinate with the child welfare and juvenile justice system on behalf of members and caregivers
• Serve as a liaison with state agencies, including and not limited to Department of Mental Health, Department of Developmental Resources, Office of Juvenile Justice, Department of Children and Family Services, Department of Elementary and Secondary Education, Medicaid Services, and consultation with the Health Plan about interaction and services to these departments
• Ability to work independently understanding individual and market goals, metrics, trends, and results
• Adhere to meeting goal targets Weekly, Monthly, and Quarterly
• Verifies appropriate ICD-10 and CPT coding usage
• Communicates to providers and members benefit determinations within assigned time frames
• Complete Health Needs Assessment (HNA) for SCYP members and stakeholders
• Complete CANS Assessment according to organization policy and procedures
• Other duties as assigned by manager and / or Health Service Director

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:

• Registered Nurse or degree in Social Work with unrestricted license in the state of LA or degree in nursing with unrestricted RN license in the state of LA
• 2+ years working with individuals with behavioral health needs
• 1+ years of experience child and youth welfare, pediatrics, or special health care needs population
• 1+ years of experience with arranging community resources/case management
• Experience with electronic charting
• Experience working in Medicaid health care and insurance industry, including regulatory and compliance requirements
• Field-based work experience
• Intermediate proficiency with software applications to include Microsoft Word, Microsoft Excel, Microsoft PowerPoint
• Computer/typing proficiency to enter/retrieve data in electronic clinical records, experience with email, internet research, use of online calendars
• Reside in the state of LA
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

• CCM (Certified Case Manager)
• 2+ years of experience in development and execution of clinical and/or behavioral health programs
• 2+ years supervisor or management experience
• 2+ years of experience in development and execution of clinical/behavioral health programs
• Knowledge of ICUE and Community care Programs

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

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)

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.