Remote / Telephonic Case Manager - Bilingual Spanish / English

Requisition Number: 2357835
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts on 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 want to achieve more in your mission of health care, you must be smart about the business of health care.
As a Remote / Telephonic Case Manager - Bilingual Spanish / English, you will work with our Medicaid members primarily focusing on our Spanish speaking population, wearing many hats. Sometimes, you'll interact with members leaving the hospital - possibly with new medications or diagnoses. You may also act as an intermediary between providers and members - serving in numerous roles, such as educator, evaluator, service coordinator, community resource researcher and more. Resulting in fewer hospitalizations, ER visits and costly service gaps; and a less stressful, more effective health care system for us all, and all from your own home.
What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
Schedule: Monday-Friday 8am-5pm PST
You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:

• Deliver a complete continuum of high-quality care through proactive and ongoing communication with members in their preferred language via phone and virtual platforms
• Assist members with safe and effective transitions from in-patient, skilled nursing, or other facility settings back to the home environment
• Coordinate follow-up appointments, services, and equipment to reduce remissions and ensure continuity of care
• Collaborate with interdisciplinary teams, providers, and facilities to support smooth transitions
• Establish therapeutic relationships with members and caregivers to support engagement, adherence, and self-management
• Conduct comprehensive, ongoing assessments to identify clinical, behavioral, and psychosocial needs
• Provide a complete continuum of quality care through close communication with members via phone interaction
• Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels
• Assist members with the transition from a care facility back to their home
• Meet NCQA Population Health Management Standards
• Meet state-specific contractual requirements related to the delivery of care management
• Provide member education on medications, disease management, and other healthcare related needs

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:

• Current, unrestricted WA state (or multi-state) RN license
• 2+ years of healthcare experience
• 1+ years of experience working with complex, high-risk, or chronic condition populations
• Intermediate level of computer/typing proficiency to enter/retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications
• Access to high-speed internet from home
• Willing and able to work in the pacific time zone
• Bilingual proficiency in English and Spanish (verbal and written)

Preferred Qualifications:

• Bachelor's degree
• Certification in Case Management (CCM)
• Case Management experience in a managed care, health plan, or value-based care environment
• Minimum of 2-3 years of care management, case management, population health, or related experience
• Medicaid Managed Care experience
• Working knowledge of NCQA Population Health Management standards
• Knowledge of community resources and social determinants of health
• Prior remote or telephonic care management experience
• Experience with vulnerable subpopulations include children and youth with special health care needs, adults with serious mental illness, members with substance use disorders and members with other complex or multiple chronic conditions
• Strong telephonic engagement and motivational interviewing skills
• WA State residence

*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 $28.94 to $51.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable .
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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