Ambulatory Care Coordinator jobs at Centene - 367 jobs

CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community‐based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Personal Care Coordinator Sr (Bilingual in Vietnamese) and help shape the future of healthcare where you'll be an integral part of our Case Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Full Telework. If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum. The Personal Care Coordinator Sr will perform a wide variety of advanced support activities for plan members. You will ensure regular communication of the member's annual Health Needs Assessment (HNA) or Health Risk Assessment (HRA) and care plan with the member, primary care provider (PCP) and health care team. You will regularly assess the quality of service given to the member's care by identifying barriers and assisting in improving these barriers for all levels of care. You will maintain strong working relationships with the PCP and health care team to ensure member access to timely services and coordination of care. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 95% ‐ Program Support Participates in a mission‐driven culture of high‐quality performance, with a member focus on customer service, consistency, dignity and accountability. Assists the team in carrying out department responsibilities and collaborates with others to support short‐ and long‐term goals/priorities for the department. Maintains strong working relationships when collaborating with the PCP and health care team to ensure timely communication of member's clinical information and ensures appropriate documentation of all interventions. Also, notifies member's care team of key event triggers. Collaborates with licensed professionals in development of a care plan for each member, incorporating the HNA or HRA all assessment findings. Facilitates communication of care plan to the PCP and member, as necessary. Develops and implements a member's specific care plan which includes prioritized Specific, Measurable, Achievable, Relevant, and Time‐Bound (SMART) goals. Facilitates and participates in interdisciplinary team meetings as applicable. Processes and maintains complex or sensitive documentation of member's case and care plan within CalOptima Health's medical management system. Facilitates referrals to Behavioral Health Services and identifies the need for referrals to Long‐Term Support Services and community resources. Facilitates transfers to member's assigned case manager in accordance with member needs, when appropriate. Anticipates longer‐term and more unique member needs by providing guidance in understanding and accessing the benefits they are entitled to under Medicare and Medi‐Cal, as appropriate. Maintains compliance with established departmental productivity guidelines; compiles and conducts basic analyses and reporting of productivity metrics to management as required. Coordinates and maintains cases in current case load in accordance with case management standards. Assists with collection of health risk or health needs assessments as well as gathers medical records as needed. Provides regular outreach to assigned members and evaluates quality of service given to members according to department contact standards. Serves as the main point of contact for assigned members to anticipate longer term member needs. Works with Case Management staff to expedite the resolution of member concerns. 5% ‐ Other Completes other projects and duties as assigned. Do You Have What the Role Requires? High School diploma or equivalent required PLUS 2 years of experience working with the needs of members, such as but not limited to pediatric members, seniors or persons with disabilities (SPD) and/or special populations (e.g., homeless or at risk of homelessness) in a customer/member service capacity required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. Bilingual in English and Vietnamese. You'll Stand Out More If You Possess the Following: Bachelor's degree in healthcare management, social work, human services or related field. 2 years of experience with health maintenance organization (HMO), Medi‐Cal and health services. Experience working with individuals with behavior health conditions or substance use disorders. What the Regulatory Agencies Need You to Possess? N/A Your Knowledge & Abilities to Bring to this Role: Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. Work independently and exercise sound judgment. Communicate clearly and concisely, both orally and in writing. Work a flexible schedule; available to participate in evening and weekend events. Organize, be analytical, problem‐solve and possess project management skills. Work in a fast‐paced environment and in an efficient manner. Manage multiple projects and identify opportunities for internal and external collaboration. Motivate and lead multi‐program teams and external committees/coalitions. Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment. Your Physical Requirements (With or Without Accommodations): Ability to visually read information from computer screens, forms and other printed materials and information. Ability to speak (enunciate) clearly in conversation and general communication. Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face‐to‐face interactions. Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting. Lifting and moving objects,

We're looking for a detail-oriented and proactive Case Management Specialist to join our team. This role is essential in supporting our agents and clients by ensuring accurate policy tracking and smooth communication. Key Responsibilities Perform data entry and maintain accurate records in our CRM system. Access and navigate insurance carrier websites to check policy statuses. Update CRM with current policy information and notes. Collaborate with agents and assist clients with questions regarding policies. Make outbound calls to carriers when needed to verify or resolve policy issues. Document all interactions and updates thoroughly. Communicate effectively via Microsoft Teams and other internal tools. Qualifications Familiarity with insurance carrier websites and processes. Comfortable making calls to carriers and handling inquiries professionally. Strong attention to detail and organizational skills. Proficient in Microsoft Teams and basic office software. Excellent communication skills (written and verbal). Ability to work independently and manage multiple tasks. Why Join Us? Opportunity to transition into a permanent or part-time role based on performance. Supportive team environment with training provided. We offer comprehensive benefits to full time employees including company paid medical, STD, LTD and life insurance; plus voluntary dental, vision, Life/AD&D insurance, 401(k) with company-matching, generous paid time off and much more. We encourage applicants of all ages and experience, as we do not discriminate on the basis of an applicant's age. ALL OFFERS OF EMPLOYMENT ARE CONTINGENT UPON PASSAGE OF A DRUG SCREEN AND BACKGROUND CHECK.

Salary Range: $54,647 - $79,237 The expected pay range is based on many factors, such as experience, education, and the market. The range is subject to change. FLSA Status:Non-Exempt Department:Health Services Reports To:Supervisor, Utilization Management GENERAL DESCRIPTION OF POSITION The Medical Management Care Coordinator I performs non-clinical supportive duties related to utilization management (UM) and care coordination for Santa Clara Family Health Plan (SCFHP) members. Routine supportive duties include but are not limited to data entry into system software applications, managing department telephone queues, and assisting with quality monitoring projects for both SCFHP lines of business in compliance with all applicable state and federal regulatory requirements, SCFHP policies and procedures, Care Coordinator Guidelines and business requirements. ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below. Follow established Health Services policies and procedures and use available resources to respond to member and/or provider inquiries and resolve any concerns in an accurate, timely, respectful, professional and culturally competent manner Collaborate with team members on improvement efforts across-departments regarding quality improvement projects, optimization of utilization management, and member satisfaction. Develop effective and professional working relationships with internal and external stakeholders and partners. Communicate effectively with members and providers orally and in writing. Assist in gathering and processing data for internal required reports and analysis. Attend and actively participate in daily, weekly, and monthly departmental meetings, in-services, training and coaching sessions. Follow UM policies and processes to the management of incoming authorization requests received through fax, mail or telephone. Identify authorization requests for line-of-business, urgency level, type of service, and assess for complete/incomplete record submission. Perform complete, accurate, and consistent data entry into system software applications in accordance with policies, procedures and instruction from UM management. Answer inbound UM phone queue calls timely to assist members and/or providers regarding inquiries involving authorizations, SCFHP program services, and/or benefits. Process written and verbal notifications of authorization determinations to members and/or providers within regulatory processing timeframes. Perform other duties as required or assigned. REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired. High school diploma or GED. (R) Minimum two years of experience in a health care setting in positions requiring interaction with members and/or providers. (R) Knowledge of health plan benefits, process and operations related to commercial, Medi-Cal and/or Medicare programs. (D) Proficient in adapting to changing situations and efficiently alternating focus between telephone and non-telephone tasks to support department operations as dictated by business needs. (R) Ability to consistently meet accuracy and timeline requirements to maintain regulatory compliance. (R) Demonstrated ability to consistently meet Key Performance Indicators by participating in and achieving the standards put forth to achieve the standard requirements of the Utilization Management Department (R) Ability to work within an interdisciplinary team structure. (R) Work weekends and company holidays as needed based on business and regulatory requirements. (R) Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications such as Outlook, Word, Excel, and specific UM programs. (R) Ability to use a keyboard with moderate speed and a high level of accuracy. (R) Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, members, providers and outside entities over the telephone, in person or in writing. (R) Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R) Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R) Ability to maintain confidentiality. (R) Ability to comply with all SCFHP policies and procedures. (R) Ability to perform the job safely and with respect to others, to property and to individual safety. (R) WORKING CONDITIONS Duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications. PHYSICAL REQUIREMENTS Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation: Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R) Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R) Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R) Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R) Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R) Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R) ENVIRONMENTAL CONDITIONS General office conditions. May be exposed to moderate noise levels. EOE (function () { 'use strict'; social Share.init(); })();

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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together The RN Clinical Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting members' medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. This is a home-office based position with field responsibilities. You will spend approximately 50% to 75% of the time in the field within an assigned coverage area. Candidates must be in Franklin County, OH and willing to commute to surrounding counties. If you reside in Franklin County, OH or surrounding counties, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team 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 independent licensure as a Registered Nurse in Ohio 2+ years of clinical experience as an RN 1+ years of experience with MS Office, including Word, Excel, and Outlook Reliable transportation and the ability to travel up to 75% within Franklin County, OH and surrounding counties in OH to meet with members and providers Reside in Franklin County, OH and surrounding counties Preferred Qualifications: BSN, Master's Degree or Higher in Clinical Field CCM certification 1+ years of community case management experience coordinating care for individuals with complex needs Experience working in team-based care Background in Managed Care *All employees working remotely 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 $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. #UHCPJ 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.

BBB National Programs BBB National Programs is where businesses turn to enhance consumer trust and consumers are heard. Privacy Coordinator WHO WE ARE We are a non-profit organization dedicated to fostering a more accountable and trustworthy marketplace. As the foremost thought leader on industry self-regulation, we are shaping the way that businesses and consumers interact with one another. As the home of U.S. independent industry self-regulation, we are currently operating more than twenty globally recognized programs that have been helping enhance consumer trust in business for more than 50 years. Our programs provide third-party accountability and dispute resolution services that address existing and emerging industry issues, create a fairer playing field for businesses, and a better experience for consumers. We continue to evolve our work and grow our impact by providing business guidance and fostering best practices in areas such as advertising, child-and-teen-directed marketing, data privacy, dispute resolution, automobile warranty, technology, and emerging areas. ABOUT OUR PRIVACY INITIATIVES BBB National Programs works with individual companies, industry groups, and regulators to develop, monitor, and enforce robust privacy standards. Our trusted privacy programs deliver independent accountability for privacy commitments, whether built on self-regulatory principles or legal requirements, tailored to respond to the unique privacy challenges presented by specific data types, like children's data, or use cases, such as emerging technologies and cross-border transfers. Together our programs drive the adoption of unified privacy practices, facilitate consumer education and choice, and offer consumers accessible, no-cost privacy dispute resolution. YOUR IMPACT The Privacy Coordinator provides day-to-day administrative, customer service, and billing support, assisting the lead(s), including the Deputy Director, Privacy Operations and Vice President, Global Privacy Division and Privacy Initiatives Operations, in administering the BBB EU-US Data Privacy Framework (DPF) Program and in implementing other related privacy initiatives, as needed, within the purview of the Privacy Initiatives team. The Privacy Coordinator assists with daily BBB National Programs DPF Program operations, including responding to applicant and participant inquiries, creating and maintaining accurate participant records, processing payments and issuing invoices. The Privacy Coordinator also supports the Program's compliance monitoring functions. ESSENTIAL DUTIES AND RESPONSIBILITIES Primary responsibility for screening new applications to the BBB EU-US DPF program, conducting initial reviews of posted privacy policies and other materials to check for eligibility. Maintains accurate records of applicants and participating businesses by updating company data in appropriate spreadsheets and databases. Serves as primary point of contact for new and renewing applicants, providing resources and general guidance, maintaining an open line of communication and responding professionally to inquiries, directing questions to management as needed. Provides guidance to participating businesses on the renewal process for both the Department of Commerce and DPF program as well as insights on other procedures such as company restructuring Monitors pending applicants, alerting management to red flags that may cause their application to be rejected. Coordinates execution and transmission of administrative documents (e.g., contracts, invoices) to new participants. Conducts reviews of all new applicant privacy policies, assisting applicants in meeting all DPF and BBB National Programs' requirements, reporting to the Deputy Director for final review. Conducts reviews of participating business compliance with DPF and Program administrative requirements during the annual account renewal process and follows up on deficiencies with participants as needed. As needed, assists Deputy Director with supporting participants as they pursue approval or re-certification from the Department of Commerce. Reports regularly to team on observed trends in the application process Provide thought leadership on trends, observations, and developments to support a forward-looking outlook for the program. Provide support to the Deputy Director and Vice President with identifying participants for the DPF verification program. WHAT YOU WILL BRING Must Have: Bachelor's degree (B. A.) degree from four-year College or university 2+ years of Privacy experience Attention to detail, organizational, and analytical skills Excellent written and verbal communication skills Proficiency in MS Office, including PowerPoint, Outlook, and Excel, and ability to work with Customer Relationship databases Self-starter with ability to multi-task on several projects Ability to create charts, graphs and tables to convey complicated information and sophisticated PowerPoint presentations about the program is highly desirable Let us know if you have: IAPP or other applicable certification (e.g. CIPP) Knowledge of international data privacy compliance, including DPF, CBPR, GDPR, or other frameworks, strongly preferred Public speaking skills, e.g. participation at industry conferences, webinar presentations, etc. WHAT WE OFFER: At BBB National Programs, we bring a growth mindset as we advance our mission and strive to foster trust, innovation, and competition in the marketplace, while cultivating a team of talented and engaged professionals who seek out new challenges and opportunities to catalyze our progress. We are an inclusive organization, bringing a dynamic environment that supports our employees and the meaningful work we do. Health & Welfare Benefits : You will be offered a comprehensive plan offering health, dental and vision plans, paid short-term disability insurance, and life insurance. Financial Well-Being : Build your retirement savings with our 401k plan matching up to 7% of your contributions. Time Off : You will have flexibility for the time you need off from work. We offer a variety of plans including vacation, personal, and sick leave. Wellness : We promote physical and mental wellness by providing a fully equipped on-site fitness center in our offices and an employee assistance program. Environment : Our modern headquarters in McLean, VA provides the space for creativity and collaboration, and the technology resources so you can be at your best. We believe that an inclusive workforce is a strength in fulfilling our mission. BBB National Programs is Great Place to Work Certified and has been named as a Best Place to Work for Working Daughters. BBB National Programs is proud to be an equal employment opportunity employer.

Salary Range: $66,273 - $99,409 The expected pay range is based on many factors, such as experience, education, and the market. The range is subject to change. FLSA Status:Non-Exempt Department:Grievance and Appeals Reports To:Supervisor, Grievance and Appeals GENERAL DESCRIPTION OF POSITION The Grievance and Appeals Coordinator is responsible for the beginning-to-end process of receiving, researching and resolving of new and existing member and provider grievance and appeals cases for all lines-of-business including any escalated step of the grievance and appeals process in accordance with state and federal regulatory requirements and SCFHP policies and procedures as set forth for each line of business. ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential duty listed below satisfactorily. Act as a back-up to the Grievance and Appeals Intake Specialist during times of high volume work and/or staffing shortages to ensure appropriate intake of new and existing grievance and appeal cases, assessing the priority of each case and routing to the appropriate staff. Ensure grievance and appeals cases are accurate and include the necessary elements for processing and resolving, giving special attention to those identified as "Expedite". Create clear and concise documentation in applicable system(s). Use good judgment and department resources to identify all issues and required actions within a case, appropriately categorize cases and identify required actions in accordance with state and federal regulations. Produce and manage outbound documents, correspondence and reports in a manner that meets required timeframes. Ensure adherence with state and federal regulatory timeframes for handling cases including acknowledging cases, resolving cases, monitoring effectuation of resolution, completing resolution letters and communicating with members and providers within required timeframes. Prepare case files for State Fair Hearings, Independent Review Entities or other escalated types of cases, including documentation of the Statement of Position and case narratives. Represent SCFHP in any hearing proceedings. Develop effective and professional working relationships with internal and external stakeholders and partners. Communicate effectively with members and providers orally and in writing. Contact members and providers to seek additional information or clarification regarding grievance and appeals cases and review and resolve issues by requesting medical records, notice of action, or any other pertinent information related to grievances and appeals from medical groups, delegated entities and/or providers. Perform complete, accurate and consistent data entry into system software applications in accordance with policies, procedures and instruction from the Manager of Grievance and Appeals Operations. Maintain case files by ensuring that they are documented in accordance with state and federal requirements and organized in a manner that adheres to SCFHP standards and audit requirements. Participate in retrospective audit and review of cases and complete and correct gaps or errors in data. Identify operational issues and trends with SCFHP, delegates and other external stakeholders. Communicate these issues internally and externally and assist in formulating appropriate remediation plans. Assist the Manager of Grievance and Appeals Operations and peers with special projects. Work collaboratively and cross-functionally with other departments to facilitate appropriate resolutions. Work as a team to complete departmental tasks to meet deadlines and accomplish department objectives. Attend and actively participate in Grievance and Appeals Committee meetings, operational meetings and department meetings, trainings and coaching sessions. Perform other related duties as required or assigned. REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired. High School diploma or GED. (R) Associate's degree or equivalent experience, training or coursework. (D) Minimum two years of experience in customer service, provider service, health service, or pharmacy in a managed care or health care environment handling escalated or complex issues. (R) Knowledge of health plan benefits, processes and operations. (R) Prior experience with commercial, Medi-Cal and/or Medicare programs and working with the underserved populations. (R) Work weekends and company holidays as needed based on business regulatory requirements. (R) Spanish, Vietnamese, Chinese, or Tagalog language bi-lingual skills. (D) Detail-oriented with the ability to conduct research and identify steps required to resolve issues and follow through to effectuation.(R) Proficient in adapting to changing situations and efficiently alternating focus between tasks to support the Grievance and Appeals Department operations as dictated by business needs (R) Ability to consistently meet grievance and appeals accuracy and timeline requirements by achieving regulatory standards. (R) Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications such as Outlook, Word and Excel. (R) Ability to use keyboard with moderate speed and a high level of accuracy. (R) Excellent communications skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, Members, Providers and outside entities over the telephone, in person or in writing. The ability to remain calm and de-escalate tense situations. (R) Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R) Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R) Ability to maintain confidentiality. (R) Ability to comply with all SCFHP policies and procedures. (R) Ability to perform the job safely with respect to others, to property and to individual safety. (R) WORKING CONDITIONS Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications. PHYSICAL REQUIREMENTS Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation: Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R) Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R) Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R) Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment; (R) Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R) Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R) ENVIRONMENTAL CONDITIONS General office and call center conditions. May be exposed to moderate noise levels. EOE (function () { 'use strict'; social Share.init(); })();

$5,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS 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. The RN Field Clinical Care Coordinator, you will be an essential element of an Integrated Care Model by relaying the pertinent information about the members' needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs. If you reside within a commutable distance to the Mystic Valley, MA and surrounding areas (Malden, Lynn, Cambridge, Somerville, Medford, Everett, Saugus, Reading, Peabody), you will have the flexibility to work telecommute* as you take on some tough challenges. This is a Field-based role. Expect to spend about 50% of your time in the field visiting our members in their homes or in long-term care facilities. You'll need to be flexible, adaptable and, above all, patient in all types of situations. Primary Responsibilities: Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: uhgbenefits 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 and unrestricted independent licensure as a Registered Nurse in the state of MA 2+ years of clinical experience Intermediate level of proficiency with MS Office, including Word, Excel and Outlook Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Ability to travel in assigned regions to visit members in their homes and/or other settings, including community centers, hospitals or providers' offices Access to reliable transportation & valid US driver's license Preferred Qualifications: Bachelor's or master's degree in nursing Certified Care Manager (CCM) 1+ years of community case management experience coordinating care for individuals with complex needs Experience working in team-based care Background in Managed Care Ability to utilize an Electronic Medical Record or other electronic platforms Bilingual 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 is needed for visits (ex. laptop, etc.) Ability to remain stationary for long periods of time to complete computer or tablet work duties *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. **PLEASE NOTE** The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus. 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 $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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. #RPO #RED

Coverage Area: Kalamazoo County, MI or surrounding area 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. TheField Care Coordinator- HIDE SNPis an essential element of an Integrated Care Model and is responsible for establishing a set of person-centered goal-oriented, culturally relevant, and logical steps to ensure that the person receiving LTSS receives services in a supportive, effective, efficient, timely and cost-effective manner. Care coordination includes case management, disease management, discharge planning, transition planning, and addressing social determinants of health and integration into the community. This position is Field Based with a Home-Based office. The expected travel time for member home visits is typically 75% within a 50-mile radius and/or 50-minute drive from your home pending business needs. If you reside in or near Kalamazoo County, MI or surrounding area, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Develop and implement care plan interventions 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 persons and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team Assess, plan, and implement care strategies that are individualized by the individual and directed toward the most appropriate, least restrictive level of care Identifies problems/barriers to care and provide appropriate care management interventions Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Provides resource support to members for local resources for services (e.g., Children with Special Health Care Services (CSHCS), employment, housing, independent living, foster care) based on service assessment and plans, as appropriate Manage the person-centered service/support plan throughout the continuum of care Conduct home visits in coordination with the person and care team Conduct in-person visits, which may include nursing homes, assisted living, hospital or home Gathers, documents, and maintains all member information and care management activities to ensure compliance with current state and federal guidelines What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: uhgbenefits 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: Must possess one of the following Current, unrestricted independent licensure as a Registered Nurse (RN) in state of Michigan Master's degree and current, unrestricted independent licensure as a Social Worker (e.g., LMSW, LCSW, LLMSW) Bachelor's degree and current, unrestricted independent licensure as a Social Worker (e.g. LLBSW, LBSW) 2+ years of experience working within the community health setting in a healthcare role 1+ years of experience with local behavioral health providers and community support organizations addressing SDoH (e.g., food banks, non-emergent transportation, utility assistance, housing/rapid re-housing assistance, etc.) 1+ years of experience working with persons with long-term care needs and/or home and community-based services 1+ years of experience working in electronic documentation systems and with MS Office (Outlook, Excel, Word) Access to reliable transportation and the ability to travel within assigned territory to meet with members and providers up to 75% of the time depending on member and business needs Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Ability to travel to Southfield, MI office for quarterly team meetings Must reside within the state of Michigan Preferred Qualifications: RN or LMSW, LLMSW, LCSW 1+ years of medical case management experience Demonstrated experience/additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care Experience in serving individuals with co-occurring disorders (both mental health and substance use disorders) Experience with MI Health Link (MMP) Experience working in Managed Care Working knowledge of NCQA documentation standards *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 $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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. #RPO #RED #RPOLinkedin

$5,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS 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. The RN Field Clinical Care Coordinator, 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 reside within the Waltham, Brookline, Natick, Framingham, Burlington, MA market and surrounding areas, you will have the flexibility to work telecommute* as you take on some tough challenges. This is a Field-based role. Expect to spend at least 50% of your time in the field visiting our members in their home. You'll need to be flexible, adaptable and, above all, patient in all types of situations. Primary Responsibilities: Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: uhgbenefits 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 and unrestricted independent licensure as a Registered Nurse for MA 2+ years of clinical experience Intermediate level of proficiency with MS Office, including Word, Excel, and Outlook Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Ability to travel in assigned regions to visit members in their homes and/or other settings, including community centers, hospitals or providers' offices Access to reliable transportation & valid US driver's license Preferred Qualifications: Bachelor's or Master's Degree in Nursing Certified Care Manager (CCM) 1+ years of community case management experience coordinating care for individuals with complex needs Experience working in team-based care Background in Managed Care Ability to utilize an Electronic Medical Record or other electronic platforms Bilingual-Spanish, Cantonese, Mandarin 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, etc.) Ability to remain stationary for long periods of time to complete computer or tablet work duties *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. **PLEASE NOTE** The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus. 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. 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. #RPO #RED

$5,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS 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. The RN Clinical Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. If you reside in the Boston, Quincy, Braintree, Dedham, Needham, MA area, you will enjoy the flexibility to telecommute* as you take on some tough challenges. This position is a field-based position with a home-based office. You will work from home when not in the field. Local travel up to 75% and mileage is reimbursed at current government rate. Primary Responsibilities: Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: uhgbenefits 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 and unrestricted independent licensure as a Registered Nurse in the state of MA 2+ years of clinical experience Intermediate level of proficiency with MS Office, including Word, Excel, and Outlook Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Ability to travel within assigned territory to meet with members and providers Access to reliable transportation & valid US driver's license Preferred Qualifications: Bachelor's or master's degree in nursing Certified Care Manager (CCM) 1+ years of community case management experience coordinating care for individuals with complex needs Background in Managed Care Experience working in team-based care Ability to utilize an Electronic Medical Record or other electronic platforms Ability to use on-line training platforms Demonstrated ability to utilize virtual care platforms 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 *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. **PLEASE NOTE** The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus. 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. 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. #RPO #RED

$5,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS 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. The RN Field Clinical Care Coordinator, you will be an essential element of an Integrated Care Model by relaying the pertinent information about the members' needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs. If you reside within Boston South, Dorchester, Jamaica Plain, West Roxbury, Mattapan, Hyde Park, Roslindale, East Boston, Charleston, Roxbury, Brighton, and Downtown Boston, MA market, you will have the flexibility to telecommute* as you take on some tough challenges. This is a Field-based role. Expect to spend about 50% of your time in the field visiting our members in their homes or in long-term care facilities. You'll need to be flexible, adaptable and, above all, patient in all types of situations. Primary Responsibilities: Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: uhgbenefits 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 and unrestricted independent licensure as a Registered Nurse for MA 2+ years of clinical experience Intermediate level of proficiency with MS Office, including Word, Excel, and Outlook Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Ability to travel in assigned regions to visit members in their homes and/or other settings, including community centers, hospitals or providers' offices Access to reliable transportation & valid US driver's license Preferred Qualifications: Bachelor's or master's degree in nursing Certified Care Manager (CCM) 1+ years of community case management experience coordinating care for individuals with complex needs Experience working in team-based care Background in Managed Care Ability to utilize an Electronic Medical Record or other electronic platforms Bilingual-Spanish, Cantonese, Mandarin 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, etc.) Ability to remain stationary for long periods of time to complete computer or tablet work duties *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. **PLEASE NOTE** The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus. 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. 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. #RPO #RED

$5,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS 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. The RN Clinical Care Coordinator will be an essential element of an Integrated Care Model by relaying the pertinent information about the members' needs and advocating for the best possible care available and ensuring they have the right services to meet their needs. If you reside in the Merrimack Valley, MA (Woburn, Reading, Wilmington) and surrounding area, you will enjoy the flexibility to telecommute* as you take on some tough challenges. This is a Field-based role. Expect to spend at least 50% of your time in the field visiting our members in their homes or in long-term care facilities. You'll need to be flexible, adaptable and, above all, patient in all types of situations. Primary Responsibilities: Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Partner and collaborate with internal care team, providers and community resources/partners to implement care plan Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: uhgbenefits 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 and unrestricted independent licensure as a Registered Nurse 2+ years of clinical experience Intermediate level of proficiency with MS Office, including Word, Excel and Outlook Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Ability to travel in assigned regions to visit members in their homes and/or other settings, including community centers, hospitals or providers' offices Access to reliable transportation and valid US driver's license Preferred Qualifications: Bachelor's or master's degree in nursing Certified Care Manager (CCM) 1+ years of community case management experience coordinating care for individuals with complex needs Experience working in team-based care Background in Managed Care Ability to utilize an Electronic Medical Record or other electronic platforms Bilingual - Spanish 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 is needed for visits (ex. laptop, etc.) Ability to remain stationary for long periods of time to complete computer or tablet work duties *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. **PLEASE NOTE** The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus. 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. 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. #RPO #RED

$5,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS 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. The RN Field Clinical Care Coordinator, you will be an essential element of an Integrated Care Model by relaying the pertinent information about the members' needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs. If you reside within Worcester, Auburn, Oxford, MA and surrounding areas, you will have the flexibility to telecommute* as you take on some tough challenges. This is a Field-based role. Expect to spend about 50% of your time in the field visiting our members in their homes or in long-term care facilities. You'll need to be flexible, adaptable and, above all, patient in all types of situations. Primary Responsibilities: Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: uhgbenefits 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 and unrestricted independent licensure as a Registered Nurse in the state of MA 2+ years of clinical experience Intermediate level of proficiency with MS Office, including Word, Excel, and Outlook Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Ability to travel within assigned territory to meet with members and providers Access to reliable transportation & valid US driver's license Preferred Qualifications: Bachelor's or master's degree in nursing Certified Care Manager (CCM) 1+ years of community case management experience coordinating care for individuals with complex needs Experience working in team-based care Background in Managed Care Ability to utilize an Electronic Medical Record or other electronic platforms Bilingual-Spanish, Khmer 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 *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. **PLEASE NOTE** The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus. 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. 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. #RPO #RED

Nurses and Social Workers! VIVA HEALTH, ranked one of the nation's Best Places to Work by Modern Healthcare, is currently seeking a Care Coordinator in Dothan, AL! VIVA HEALTH knows that nursing and social work is not just a job, it is a calling. If you would like to fulfill your calling in healthcare, check us out! We offer regular hours with no mandatory nights or weekends. This way you can do what you love at work and can take care of the people you love at home! We also offer a great benefits package including tuition reimbursement for employees and dependents, paid parental leave, and paid day for community service, just to name a few! VIVA HEALTH employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. Come join our team! Care Coordinators use psychosocial and/or clinical knowledge to provide non-clinical services for Medicaid recipients to improve the medical compliance and health outcomes of the populations served. This position identifies barriers to medical compliance such as lack of transportation, illiteracy, or other social determinants that impact a member's health, and ensures services are delivered and continuity of care is maintained. The position analyzes the home and community environment and makes autonomous decisions regarding appropriate care plans and goals using a thorough knowledge of available community resources. These services are provided primarily in community and home settings via phone and/or in person. Local daytime travel is required via a reliable means of transportation insured following Company policy. This position will have work-from-home opportunities. GENERAL CARE COORDINATION REQUIRED: * Licensed BSN/ADN * Licensed BSW PREFERRED: * Licensed MSW and/or Certified Case Manager (CCM) designation * Experience in case management, human services, public health, or experience with the underinsured population Also requires a valid driver's license in good standing, willingness to submit to vaccine testing and screening, and may require significant face-to-face member contact with duties performed away from the principal place of business. All positions require excellent interview and telephone skills as well as the ability to deal with recipients in a caring and helpful manner. The Care Coordinators should have a working knowledge of health-related service delivery systems and excellent communication and relationship skills. This position requires the ability to analyze varied environmental factors to members' well-being and work independently in an autonomous setting and the ability to locate, augment, and develop resources, including information on services offered by other agencies.

An ECM Coordinator supports department staff with administrative tasks related to a member's medical condition(s), department case work, communication with internal and external stakeholders, and manage audits. This role will engage with members to offer support and resources related to their medical condition(s) through Allied Care. ESSENTIAL FUNCTIONS Facilitate reviews, referrals, and outreach for referral-based proprietary strategies as well as engaging with members across Medical Management products Document all engagement accurately and concisely within the Microsoft Customer Relationship Management (CRM) system Manage escalated and time sensitive case management questions received from members, broker relationships, and internal and external Allied stakeholders Collaborate with strategic vendor partners to provide supportive services and support to members Lead and facilitate claims auditing in conjunction with ECM Coordinators. Complete department auditing related to daily tasks to ensure accuracy and identify escalations Identify impactful scenarios through appropriate closing summaries in timely fashion. Share impactful scenarios with the department's leadership team to deliver to internal departments, such as Sales, Operations, and Executive leadership Identifying escalations for department leadership team, as appropriate Other duties as assigned EDUCATION Bachelor's Degree or equivalent work experience, required EXPERIENCE AND SKILLS At least 3-5 years of administrative support experience required. Focus on patient-provider engagement, needs assessments, coordination of care, and or patient treatment adherence within the healthcare or social service industry preferred Understanding of intermittent medical terminology such as CPT, HCPC, and diagnostic codes Understanding of basic benefit plan design terminology such as deductible, out-of-pocket, prescription drugs, physical medicine services, etc. Strong verbal and written communication skills Strong analytical and problem-solving skills COMPETENCIES Communication Customer Focus Accountability Functional/Technical Job Skills PHYSICAL DEMANDS This is a standard desk role - long periods of sitting and working on a computer are required. WORK ENVIROMENT Remote Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive. The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend. Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role. Protect Yourself from Hiring Scams Important Notice About Our Hiring Process To keep your experience safe and transparent, please note: All interviews are conducted via video. No job offer will ever be made without a video interview with Human Resources and/or the Hiring Manager. If someone contacts you claiming to represent us and offers a position without a video interview, it is not legitimate. We never ask for payment or personal financial information during the hiring process. For your security, please verify all job opportunities through our official careers page: Current Career Opportunities at Allied Benefit Systems Your security matters to us-thank you for helping us maintain a fair and trustworthy process!

--------------------------------------------------------------- The Intensive Care Coordinator (ICC) is responsible for developing and implementing member-centric, individualized care plans and providing telephonic and community-based care coordination for members with high health care needs, including members with complex behavioral concerns, severe and persistent mental illness, substance use disorders, and/or receiving facility based, in-home or community-based psychiatric services. The ICC utilizes clinical expertise in behavioral health conditions and knowledge regarding the adult and children's system of care to provide coordination that is member driven, strengths based, and culturally and linguistically appropriate. The ICC acts as the primary care coordination liaison for providers working with members involved in, on waitlists for, or who may qualify for, Wraparound or Choice Model Services. NOTE: This hybrid role averages 2-3 partial days per week in the community, with the remainder of work done remotely from home. Estimated Hiring Range: $81,000.00 - $99,000.00 Bonus Target: Bonus - SIP Target, 5% Annual Current CareOregon Employees: Please use the internal Workday site to submit an application for this job. --------------------------------------------------------------- Essential Responsibilities Assessment and Care Planning * Assess for and identify care coordination needs. * Identify risk factors and service needs that may impact member outcomes and address appropriately. * Utilize a trauma-informed approach to provide member-centric care and support. * Assist in helping members move through the continuum of care based on clinical/medical need. * Coordinate with providers to ensure consideration is given to unique needs in integrated planning and that care plans are timely and effective. * Identify suspected abuse and neglect issues and appropriately report to mandated authorities. * Implement care coordination plan in collaboration with member, providers, case workers and other relevant parties. * Work closely and collaborate with behavioral health treatment providers, crisis services, Developmental Disability, APD, DHS, etc. Intensive Care Coordination * Provide telephonic and community-based care coordination to eligible members and families. * Provide support and coordination for members receiving treatment in the higher levels of behavioral health care such as psychiatric residential treatment, intensive community based or psychiatric day treatment. * Ensure treatment recommendations are understood by the member and provider and assist members through transitions to the next level of care or treatment provider. * Facilitate communication between members, their support systems other community-based partners and clinical care providers and ensure care plans are shared, as appropriate. * Forward relevant information of members requiring special consideration of benefits to Medical Management Review RNs or to affiliated CareOregon programs. * Serve as a resource to the organization on mental health and substance use topics and issues. * Accept assignment of and maintain a caseload of members. * Effectively coordinate an interdisciplinary team for integrated care plan support of complex members. * May participate in monthly state hospital IDT meetings as well as discharge planning meetings. * Participate in CCO/APD IDT meetings to coordinate care services for OHP members in long term care services. * Collaborate with community providers, state and county case workers, community partners, vendors, agencies, Choice contractors, wraparound teams, and other relevant parties * Provide direction as appropriate to non-clinical Care Coordination staff involved with the member Transition Assistance * Assist in transition/discharge planning for members discharging from acute care settings or those who are transitioning from long term care, the Oregon State Hospital or other residential facilities to ensure a smooth transition back to community-based supports. * Ensure discharge/transition plans are evaluated holistically from physical and behavioral health perspectives. * Ensure members on the state hospital Ready to Transition (RTT) list are prioritized for referral into appropriate transition setting through collaboration with and community partners including the CHOICE ENCC. * May compile and distribute referral packets to residential and foster care facilities as needed. * Coordinate care for members residing outside of service area as required in contract. Compliance * Maintain unit compliance with Coordinated Care Organization requirements. * Maintain tracking data for program evaluation and reporting purposes. * Maintain timely and accurate documentation about each member per program policies and procedures. * Maintain working knowledge of COA and OHP benefits, including Addictions and Mental health benefits. * Report member complaints to Appeals and Grievance team for investigation and follow-up, per protocol. * Participate in quality and organizational process improvement activities and teams when requested. * Assist Quality Assurance (QA) staff in identifying behavioral health providers with practice patterns which are not in conformity to best practice standards. * Maintain unit compliance with the Model of Care requirements if applicable. Organizational Responsibilities * Perform work in alignment with the organization's mission, vision and values. * Support the organization's commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals. * Strive to meet annual business goals in support of the organization's strategic goals. * Adhere to the organization's policies, procedures and other relevant compliance needs. * Perform other duties as needed. Experience and/or Education Required * Master's degree in social work, counseling or other behavioral health field * Minimum 2 years' experience in mental health and/or drug and alcohol treatment for the population being served * Valid driver's license, acceptable driving record, and automobile liability coverage or access to an insured vehicle Preferred * Experience with a similar population in health plan case management/care coordination or behavioral health integration in a person-centered primary care home, experience administering the Oregon Health Plan (OHP) (Medicaid) and the Centers for Medicare and Medicaid Services (CMS) (Medicare) benefits * Related experience in the use of Motivational Interviewing (MI) * Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), or equivalent * Certification as CCM (Certified Case Manager) and/or Certified Alcohol Drug Counselor II or III (CADC II or III) Knowledge, Skills and Abilities Required Knowledge * Knowledge of current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for mental health and substance dependence/abuse diagnoses, ASAM (American Society of Addiction Medicine) criteria for alcohol and/or drug dependence treatment and Mental health * Knowledge of best practices and treatment modalities * Knowledge of co-morbidities that indicate potential for psychiatric de-compensation and/or relapse * Knowledge of side effects of psychotropic medications that may impact health status and adherence with treatment recommendations and behavioral health integration in primary care settings * Knowledge of the Oregon Health Plan benefit package, eligibility categories, and Oregon Medical Assistance Program (MAP) rules and regulations * Knowledge of Medicare parts A and B benefit packages and the Centers for Medicare and Medicaid Services (CMS) rules and regulations and community resources * Knowledge of community resources Skills and Abilities * Ability to exercise sound clinical judgment, independent analysis, critical thinking skills, and knowledge of behavioral health conditions to link members with appropriate providers * Ability to meet department standards for competency in the use of motivational interviewing within 12 months of hire, collaborate with members, providers, and community partners to develop plans to address complex care needs and monitor and evaluate a plan of care for optimal outcomes * Ability to work in an environment with diverse individuals and groups * Ability to establish collaborative relationships and effectively lead a multidisciplinary team * Ability to manage multiple tasks and to remain flexible in a dynamic work environment and work autonomously and effectively set priorities * Ability to participate in work-related continuing education when offered or directed * Ability to provide excellent customer service and verbal and written communication * Basic word processing skills * Ability to learn, focus, understand, and evaluate information and determine appropriate actions * Ability to accept direction and feedback, as well as tolerate and manage stress * Ability to see, read, hear, speak clearly, and perform repetitive finger and wrist movement for at least 6 hours/day * Ability to operate a motor vehicle Working Conditions Work Environment(s): ☒ Indoor/Office ☒ Community ☐ Facilities/Security ☒ Outdoor Exposure Member/Patient Facing: ☐ No ☒ Telephonic ☒ In Person Hazards: May include, but not limited to, physical, ergonomic, and biological hazards. Equipment: General office equipment and/or mobile technology Travel: Requires travel outside of the workplace at least weekly; the employee's personal vehicle may be used. Driving infractions will be monitored in accordance with organizational policy. If you receive an offer of employment for this position, it is contingent on the satisfactory completion of a pre-employment background check, immunization review, and drug screen (including THC/Marijuana). CareOregon is a federal contractor and must comply with all federal laws. If you receive an offer of employment for this position, it is contingent on the satisfactory completion of a pre-employment background check, immunization review, and drug screen (including THC/Marijuana). CareOregon is a federal contractor and must comply with all federal laws. We offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information. We are an equal opportunity employer CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.

Job DescriptionMCCN Care Coordinator 40hrs per week (Hybrid - Remote flexibility when not working in the field) General Statement of Duties: The MCCN Care Coordinator will provide LTSS care coordination activities to youth and adult Enrollees of MCCN to facilitate the appropriate delivery of health care services and improve health outcomes. Such activities may include organizing care and facilitating communication across medical, behavioral health, LTSS, social, and pharmacy providers, agencies, and supports. This position requires regular travel within the Southeast Region. Efforts will be made to contain travel within 1 hour of the Brockton office or the applicant's home, but occasional travel outside 1 hour radius may occur. Responsibilities: Work collaboratively and effectively with care management, including Assigned or Engaged Enrollee, medical team and other providers to provide LTSS care management services. Work collaboratively with the care team to complete and utilize the Comprehensive Assessment results, and work with Assigned or Engaged Enrollee to develop or update the LTSS Person Centered Treatment Plan within 122 days of assignment. Ensure that the LTSS Person Centered Treatment Plan meets the requirements of EOHHS and notify the care team if changes have occurred to Assigned or Engaged Enrollee's functional status, including Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) needs, since the completion of the Comprehensive Assessment. Ensure the Assigned or Engaged Enrollee receives necessary assistance and accommodations to prepare for, fully participate in, and to the extent preferred, direct the care planning process. Ensure that the Assigned or Engaged Enrollee receives assistance in understanding LTSS terms and LTSS concepts, including but not limited to information on their functional status; how family members, social supports and other individuals of their choosing can be involved in the care planning process; self-directed care options and assistance available to self-direct care; and LTSS services or programs that are available to meet their needs and for which they are potentially eligible. Inform the Assigned or Engaged Enrollee about his or her options for specific LTSS services and programs and providers that may meet their needs. Assess the Assigned or Engaged Enrollee for social services and identify community and social services and resources that may support the health and wellbeing of the Assigned or Engaged Enrollee. Conduct assessment for Flexible Services for all Assigned or Engaged Enrollees who are enrolled in an ACO. If Flexible Services are identified, make recommendation to ACO for approval. Coordinate all aspects of service delivery and promote integration with health care providers, BH providers, LTSS providers and community/social service provides that the Assigned or Engaged Enrollee may be receiving, as outlined in the LTSS Person Centered Treatment Plan. Participate in Enrollee's care team meetings to ensure effective communication among all disciplines involved in individual's care. Provide health and wellness coaching as directed by the Engaged Enrollee's care team and as indicated in the Enrollee's LTSS Person Centered Treatment Plan. Maintain regular contact with Assigned or Engaged Enrollee to monitor and coordinate LTSS Person Centered Treatment Plan including quarterly face-to-face meetings. Care Coordination activities include visiting locations in which the Enrollee is known to reside or visit; Conducting face-to-face home visits with the Enrollee on an initial and quarterly basis; complete in person follow up after discharge visit within 7 days following an Enrollee's inpatient discharge, discharge from twenty-four (24) hour diversionary setting, or transition to a community setting. Support transitions of care by completing a follow up within seven (7) calendar days following an Enrollee's emergency department (ED) discharge. Coordinates clinical services and other supports for the Enrollee, as needed Contacting the Enrollee's providers and collaterals to ensure accurate contact information when Assigned or Engaged Enrollees become unreachable. Qualifications: BA in social work, human services, nursing, psychology, sociology, or related field from an accredited college/university OR an Associate's degree and at least one year professional experience in the field OR at least three years of relevant professional experience. Experience working with individuals with complex LTSS needs and credentialed as a community health worker, health outreach worker, peer specialist, or recovery coach desired. Care Coordination and Behavioral Health experience preferred. Experience in navigating individual and family service systems and demonstrated the capacity to work collaboratively and effectively with families and community-based colleagues. Ability to use Electronic Health Records (EHR) Systems to document and coordinate services. Must be able to perform each essential duty satisfactorily. Strong interpersonal skills in terms of developing a working relationship with a variety of individuals in a variety of context. Ability to communicate effectively verbally and in writing. Strong organization skills with Attention to detail, multi-tasking skills, Prioritization skills, Analytical skills, Problem-solving skills, and Team skills. Strongly prefer that a candidate will have a demonstrated understanding of and competence of Health Equity and in serving culturally diverse populations. Commitment to MCCN values and mission. Ability to travel on a regular basis; Must have valid driver's license and access to an automobile. Ability to read and speak English. Fluency in other languages, including Spanish, Cape Verdean Creole, Haitian Creole preferred. Strongly preferred experience in Microsoft Products and software i.e., Teams, Excel, Word, Outlook, etc. Strong computer knowledge, including proficiency in contemporary Windows operating systems and Windows office suites with an emphasis on Word and Excel; ability to learn new systems; experience entering and working with data; and comfort and experience using mobile technologies. Knowledge regarding psychiatric rehab and understanding of recovery model. Strongly prefer that a candidate will have a demonstrated understanding of and competence of Health Equity and in serving culturally diverse populations. Must be able to perform each essential duty satisfactorily. Must hold a valid drivers' license. Must have access to an operational and insured vehicle and be willing to use it to transport members. Must have ability to read English and communicate effectively in the primary language of the program to which he/she is assigned. EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER We at BAMSI appreciate your interest and consideration of roles in our organization. BAMSI is an equal opportunity and Affirmative Action Employer encouraging diversity in the workplace. All qualified applicants will receive consideration for employment without regard to their race, color, creed, religion, ancestry, national origin, sex, sexual orientation, gender identify, age, marital status, family responsibilities, pregnancy, genetic information, protected veteran or military status and regardless of whether the qualified applicants are individuals with disabilities. EEO is the Law ***************************************** Reasonable Accommodations for Applying/Recruitment Reasonable accommodations are adjustments made to remove workplace obstacles for qualified individuals with disabilities to apply for and perform their jobs. Applicants who qualify under the Americans with Disabilities Act, as amended, may be eligible for a reasonable accommodation in BAMSI's application and selection process. A request for an accommodation will not affect opportunities for employment within BAMSI. Arrangements can be made if you have a disability that requires an accommodation for completing an application form, interviewing or any part of the employment process. Requesting accommodations, in writing or verbally, can be initiated by a BAMSI employee, qualified applicant, or by someone acting on that person's behalf. Either call ************ or, send letter to Talent Acquisition, 15 Christy's Dr Brockton, MA 02301. Note: please do not use these contacts to follow-up on job inquiries.

In an environment of continuous quality improvement, the Denials Management Coordinator is responsible for reviewing all denials to determine patterns in errors, payors, and internal processes to improve our denial rate. Exhibits the MHS Standards of Excellence and exercises strict confidentiality at all times. Job Functions: Analyzes all denials for patterns. Works with front line staff and educate on proper processes. Ability to verbalize to insurance carriers and write appeal details to support additional payment on denied claims. Accurately and consistently documents the results of all denial reviews in the hospital information system. Prepares reports as required by management regarding audit results, process improvement recommendations and systemic payment errors. Makes monthly observations and recommendations to prevent future denials. Assumes all other duties and responsibilities as necessary. Qualifications Minimum Education/Experience Required: High School Diploma or GED required. Minimum of two years of previous experience in a healthcare-related position required. Experience in coding, medical necessity, registration, insurances, and precertification processes and/or denials preferred. Minimum of 2 years of experience or formal education in basic ICD10 coding, medical terminology, Anatomy/pathophysiology, and disease process preferred. Depending on healthcare-related experience, may require coding certification within 2 years of date of hire. Experience reviewing ambulatory claim denials preferred. Special Knowledge, Skills, Training: Computer skills (word processing, spreadsheet, graphics, and database software applications). Strong quantitative, analytical and organization skills. Strong negotiation skills. Proficient in payment review systems, hospital information systems and coding methodologies. Ability to understand medical records, hospital bills, and the charge master. Ability to understand all ancillary department functions for the facility. Ability to understand complex insurance terms and payment methodologies. Ability to effectively negotiate with insurance carriers and customers. Ability to utilize and understand computer technology. Ability to communicate orally and in written form. Team-orientated with strong interpersonal skills. Compensation Details: Education, experience, and tenure may be considered along with internal equity when job offers are extended. Benefits: Memorial Health System is proud to offer an affordable, comprehensive benefit package to all full time and flex time employees. To learn more about the many benefits we offer, please visit our website at ************************** Bonus Eligibility: Available to qualifying full or flex time employees. Eligibility will be determined upon offer. Memorial Health System is an equal opportunity provider and employer. If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at ******************************************* or at any USDA office, or call ************** to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, S.W., Stop 9410, Washington, D.C. 20250-9410, by fax ************** or email at ***********************. * Memorial Health System is a federal drug-free workplace. This policy prohibits marijuana use by employees.

Are you a compassionate individual who enjoys helping others achieve their personal health and wellness goals? If so, a career as a CHOICES Care Coordinator might be perfect for you. As a Care Coordinator, you will make a lasting impact on members' lives by ensuring their safety at home or within a community setting. In this role, you'll travel to member's homes for visits, while managing various demands and requests from both internal and external stakeholders. We're seeking individuals who excel in problem-solving through critical thinking, and who are adept at time management and prioritizing daily tasks. You should be self-motivated, flexible, and thrive in a fast-paced environment. Most importantly, you should have a passion for improving the quality of life for diverse members in their communities. You will be a great match for this role if you have: • 3 years of experience in a clinical setting • Registered nurse with an active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Act; or Masters in Social Work with an active unrestricted license (LCSW, LMSW, or LAPSW). • Exceptional customer service skills • Must live within the following counties: Memphis/Shelby County • Available for an 8:00am - 5:00pm EST(no on call) schedule, with the option (upon management approval) to work a compressed work week after 1 year. Job Responsibilities Partnering with members and families to identify needed supports and direct services to meet personal goals for good health, employment and independent or community living. Collaborates with a team of clinical and social support colleagues to meet the physical, behavioral health and long term service needs of each member. Conduct thorough and objective face-to-face visits with and assess each members situation to determine current status and needs, including physical, behavioral, functional, psycho-social, financial, and employment and independent living expectations. Utilizing criteria for authorizing appropriate home and community based services and confirm those services are being provided and that members needs are being met. Valid Driver's License. TB Skin Test (applies to coordinators that work in the field). Position requires 24 months in role before eligible to post for other internal positions. Various immunizations and/or associated medical tests may be required for this position. Job Qualifications Experience 2 years - Clinical experience required Skills\Certifications PC Skills required (Basic Microsoft Office and E-Mail) Effective time management skills Excellent oral and written communication skills Strong interpersonal and organizational skills License Registered nurse with an active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Act; or Masters in Social Work with an active unrestricted license (LCSW, LMSW, or LAPSW). Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis* will be automatically enrolled into the BCBST Driver Safety Program. The employee will also be required to adhere to the guidelines set forth through the program. This includes, maintaining a valid driver's license, auto insurance compliance with minimum liability requirements; as defined in the “Use of Non BCBST-Owned Vehicle” Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR). *The definition for "routine basis" is defined as daily, weekly or at regularly schedule times. Number of Openings Available 1 Worker Type: Employee Company: VSHP Volunteer State Health Plan, Inc Applying for this job indicates your acknowledgement and understanding of the following statements: BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law. Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.