Special Needs Coordinator - Telecommute in Columbia, MD

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.

If you reside in Maryland, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities
• Coordinate care for highly complex members as part of an inter-disciplinary care team approach
• Consult and collaborates with local health departments, primary care providers, Federally Qualified Health Centers (FQHCs), social service agencies and specialty care services to address member complex care needs
• Referrals to the REM (Rare and Expensive Medical special needs care management) program including outreach, education and coordination of the member transfer and serving as a liaison with MDH REM office
• Ensures appropriate re-direct for members to in-network specialty services as needed working closely with the Prior Authorization team
• Serve as a Housing coordinator which requires understanding of county based resources
• Educate Local Health Departments and Community Advisory Committee attendees about Plan programs and services
• Represent Special Needs Members at Plan’s Quarterly Consumer Advisory Board

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
• Current unrestricted nursing license (e.g, LPN, LVN) OR Bachelor’s level Social Worker (licensed or non-licensed) with work experience in a health care setting
• 3+ years of experience in a clinical or managed care setting
• Experience with care coordination or case management
• Experience with arranging community resources
• Experience providing clinical care to low income population
• Understanding of Medicaid member needs and benefits
• Computer/typing proficiency to enter/retrieve data in electronic clinical records and documentation systems; experience with email, internet research, use of online calendars and other software applications
• Proficient with Excel to create and pull reports

Preferred Qualifications
• 5+ years of experience in a clinical or managed care setting
• Experience and comfortability collaborating with providers and State partners
• Experience with EMR [Electronic Medical Records] and care management platforms including the State Health Information Exchange [CRISP]
• Proven ability to think creatively and work comfortably within a hands-on, fast-paced, high demand environment
• Proven ability to work with diverse care teams in a variety of settings
• Proven ability to exhibit independent clinical judgment, but the ability to consult and engage with other team members for improved patient outcomes
• Proven excellent administrative, organizational and verbal skills
• Proven effective time management and prioritization skills for competing demands
• Proven comfort with ambiguity, willingness to adjust as demands change and evolve
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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

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