In this Telephonic Case Manager role, you will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available and ensuring they have the right services to meet their needs.
If you are located within the state of
Michigan, you will have the flexibility to be telecommute* as you take on some tough challenges. Potential for up to 10% of travel.
Primary Responsibilities:- Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care
- 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 telephonic care management to members on caseload including specialized populations such as CSHCS members
- Support Care Management efforts to outreach members recently discharged from the hospital to determine needs and prevent avoidable readmissions
- Present and participate in Interdisciplinary rounds
- Collaborate with Medical Directors regarding member needs and complex issues
- Support Quality and Population Health initiatives as requested
- Participate in work groups to assist with processes and workflows
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 LMSW in the State of Michigan
- 4+ years of experience working within the community health setting in a health care role/clinical health care role
- 2+ years of case management experience
- 1+ years of experience working with MS Word, Excel, and Outlook
- 1+ years of experience with Michigan Medicaid managed care
- 1+ years of experience with medically complex pediatric members
- Access to reliable transportation & valid US driver's license
Preferred Qualifications:- Certification in Case Management
- Background in managing populations with complex medical or behavioral needs
- Telephonic Case Management experience
- Experience with electronic charting
- Experience with arranging community resources
- Experience in Utilization Management, Home Health and/ or Discharge Planning
- Medicaid, Managed Care experience
- Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
- Experience using multiple systems to retrieve member data
- Problem solving experience; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
*All Telecommuters 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 $29.00 to $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
