RAE Liaison – Case Management Agency – LTSS – Remote within Western Region of Colorado Preferred – (Mesa, Lake, Chaffee, Custer, Freemont, Alamosa, Saguache, Mineral, Rio Grande, Costilla, Conejos cou in Englewood, CO

RAE Liaison - Case Management Agency - LTSS - Remote within Western Region of Colorado Preferred - (Mesa, Lake, Chaffee, Custer, Freemont, Alamosa, Saguache, Mineral, Rio Grande, Costilla, Conejos cou - UnitedHealth Group - Englewood, CO - work from home job

Company: UnitedHealth Group

Job description: 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.

Position in this function supports corporate objectives by utilizing a demonstrated competency of Long Term Services and Supports to serve as the liaison between the RAE, contracted providers and the CMA; collaborating with stakeholders; and working to resolve issues to make sure members receive the services they need. Provides Case Management services as needed. Participates in case conferences with the Supervisor. This position is designated as Key Personnel in the contract.

If you are located within Western Region of Colorado Preferred (Mesa, Lake, Chaffee, Custer, Freemont, Alamosa, Saguache, Mineral, Rio Grande, Costilla, Conejos counties), you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities: • Serves as the liaison between the RAE, contracted providers and the CMA; collaborating with stakeholders; and working to resolve issues to make sure members receive the services they need. Provides Case Management services as needed. Ensures proper follow-up and communication to support members in obtaining and maintaining their benefits • Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. Maintain confidentiality of patient information. The ability to maintain confidentiality is a critical and essential component of this position • As needed, may provide case management services that includes intake/screening/referral, assessment/reassessment, development of support plans, on-going case management, monitoring of the Member’s health and welfare, documentation of contacts and case management activities in the Department-prescribed IMS, resource development, and case closure • Contact the Member’s at least once within each quarterly period, or more frequently if warranted by the Member’s condition /or as determined by the rules of the LTSS Program in which the Member’s is enrolled • Conduct face-to-face contact with the Member’s at least every six (6) months, or more frequently if warranted by the Member’s condition or the rules of the LTSS Program in which the Member is enrolled, and shall update the current approved assessment tool and Support Plan in the appropriate documentation system to reflect any changes in condition or services • Complete a new assessment during a face-to-face reassessment annually, or more frequently if warranted by the Member’s condition or if required by the rules of the LTSS Program in which the Member is enrolled. Complete additional assessments as needed/required • Monitor the delivery of services and supports identified within the Support Plan and the Prior Authorization Request (PAR) • Determine the Member’s level of need for case management services • Attend Department provided training for CMA agencies as well as agency provided in-service and staff development training • Conduct work that is in accordance with the CMA Contract Agreement’s requirements. This includes but is not limited to, providing work that is accurate, timely, and complete • In the event, at any time throughout the case management process, the case manager suspects an individual to be a victim of mistreatment, abuse, neglect, exploitation or a harmful act, the case manager shall immediately refer the individual to the protective services section of the county department of social services of the individual's county of residence and/or the local law enforcement agency • May take on special assignments and projects on an as needed basis. Assist with system assessment and development as needed • This position requires travel. Requires independent, reliable, flexible, and on-demand, transportation at the incumbent’s expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage

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: • Meet one of the following: • Bachelor’s degree in one of the human behavioral science fields such as human services nursing, social work, psychology, public health

5+ years of relevant experience in the field of LTSS, which includes developmental disabilities * Combination of education and experience that would enable performance of the full scope of the position. Relevant experience is defined as
• Experience in one of the following areas: long-term care services and supports, gerontology, physical rehabilitation, disability services, children with special health care needs, behavioral science, special education, public health or nonprofit administration, or health/medical services, including working directly with persons with physical, intellectual or developmental disabilities, mental illness, or other vulnerable populations as appropriate to the position being filled; and,
• Completed coursework and/or experience related to the type of administrative duties performed by case managers may qualify for up to 2 years of required relevant experience
• 1+ years of experience with MS Office, including Word, Excel, and Outlook
• Reliable transportation and the ability to travel up to 25% within assigned territory to meet with members and providers

Reside in Western Region of Colorado (Mesa, Lake, Chaffee, Custer, Freemont, Alamosa, Saguache, Mineral, Rio Grande, Costilla, Conejos counties)

Preferred Qualifications: • Experience as a caseworker or case manager with LTSS population, in a private or public social services agency may substitute for the required education on a year for year basis • Knowledge and experience in the Colorado’s Accountable Care Collaborative (ACO)

Physical Requirements: • Ability to transition from office to field locations multiple times per day • Ability to navigate multiple locations/terrains to visit employees, members and/or providers • Ability to transport equipment to and from field locations needed for visits (ex. laptop, stethoscope, etc.) • Ability to remain stationary for long periods of time to complete computer or tablet work duties

Colorado Residents Only: The hourly range for Colorado residents is $22.45 to $43.89. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
• 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.

Expected salary: $22.45 - 43.89 per hour

Location: Englewood, CO

Job date: Sat, 02 Sep 2023 22:54:32 GMT

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