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We are looking for a Clinical Care Coordinator as an addition to the UHC Spectrum Team. Spectrum Clinical Care Coordinator is responsible for ongoing Clinical Care Coordination and Care Management for patients attributed to Physician/Physician Practices participating in UnitedHealthcare’s UHC Spectrum Program.
The Clinical Care Coordinator drives Referral Management and appropriate sites of service, facilitates Care Transitions and Care for High-Risk patients; Collaborates with PCP, Specialists, and Spectrum Clinical Pharmacist to ensure appropriate, coordinated service delivery. This position integrates pharmacy management, care coordination, utilization management, and care transition management.
If you are located in Baltimore, Maryland, you will have the flexibility to telecommute* as you take on some tough challenges. This position will have daily travel expectations of the market region.
Primary Responsibilities:
- Consult with patients identified by PCP as needing a Specialist Referral to recommend High Quality, Lower Cost Premium Designated Specialists; facilitates appointments with Specialists
- Facilitate discharge information provided to Care Team and Primary Care Offices using appropriate Technology tools
- Consult with patients who have had an Inpatient/ER Discharge; facilitates scheduling transitions of care follow up appointments with PCP/Specialists
- Track completion of Referral, Care Transition, and PCP appointments with ongoing communication to patients while discussing adherence with Care Plan
- Check-in on the patient as needed to evaluate and document his/her progress as it relates to care coordination and management responsibilities tied to the Spectrum Program to collaborate with Care Team and PCP regarding patient needs and potential barriers to adherence
- Educate patients about their condition, medication, benefit plan, and care path
- Notify PCP and Pharmacist on the Care Team of relevant clinical information gathered during calls to patient that may affect the patient’s disease state or medication regimen
- Develop solid relationships with Physician offices participating with Spectrum program by communicating program goals, patient needs, and value-based opportunities
- Facilitate and/or lead meetings with Physician offices for initial onboarding meetings and ongoing collaboration meetings
- Communicate with Physician office to problem-solve patient issues and/or help facilitate communication between practice staff and Care Team
- Able to take initiative and work independently in a fast-paced environment
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 licensure as a Registered Nurse or Licensed Social Worker (LCSW)
- 4+ years Case Management and/or Care Coordination experience
- Background in managing populations with complex medical or behavioral needs
- Ability to prove solid technical knowledge of Microsoft Excel; ability to quickly learn Clinical Applications
- Ability to travel up to 25% to local office(s) to accommodate business needs within the Baltimore MD regional area (qualified candidates must reside in the Baltimore MD regional area to perform these responsibilities)
- Ability to provide proof of a valid Driver’s License and current Auto Insurance
- Full COVID-19 vaccination is an essential requirement 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
Preferred Qualifications:
- Bachelor’s degree
- Clinical or Behavioral Health degree
- Background in healthcare setting with an understanding of chronic conditions and best practices
- Solid communication skills with patients, providers, and other healthcare professionals
- Solid emotional intelligence with ability to remain focused and calm when navigating many tasks in a fast-paced environment
- Ability to work flexible schedule to accommodate business needs
- Bilingual English/Spanish
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 with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.