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SW or RN Field Care Coordinator - Pittsburgh, KS

UnitedHealth Group

Pittsburgh, KS
Job Code:
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Job Details

SW or RN Field Care Coordinator - Pittsburgh, KS(Job Number:729884)

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)


The Field Care Coordinator is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating).  This includes case management, coordination of care, and medical management consulting.  May also be responsible for providing health education, coaching and treatment decision support for members. 


This is a field-based position covering Crawford & Cherokee County, KS


Work schedule: Monday - Friday, 8am - 5pm, no weekends, on-call or holiday coverage!


 Primary Responsibilities:

  • Primarily provides care coordination / case management for members who are eligible for Nursing Facility Level of Care / Waiver services in a community or facility setting and are at high risk for clinical complication and/or have complex care management / coordination needs
  • Conducts face to face and telephonic member needs assessments according to state and national guidelines, policies, procedures, and protocols
  • Determines member’s overall bio-psychosocial needs and develops individualized member service / care plan including long term care services and supports based on assessment data, member and caregiver / stakeholder input, and cost-effective options for service delivery
  • Provides options and choices for long term care community or facility-based service delivery 
  • Develops member goals of care and interventions for unmet needs in coordination with the member 
  • Facilitates authorization, coordination, continuity and appropriateness of  care and services in community or LTC setting 
  • Routinely and as needed evaluates the effectiveness of the care / service plan and makes appropriate revisions per policy & procedure / state contractual requirements
  • Facilitates appropriate member referrals to special programs such as Disease/Chronic Condition Management, Behavioral Health, Advanced Illness, Complex Case Management
  • Coordinates benefits through other available payment sources
    Assists the member to access community, Medicare, family and other third-party resources as appropriate 
  • Facilitates care setting transitions and access to special programs (e.g. Hospital to Home, Advanced Illness, transition from Nursing Facility to community setting)
  • Collaborates and communicates with the member’s health care and service delivery team to coordinate the care needs for the member
  • Provides education to members regarding health care needs, available benefits and services
  • Works to facilitate member compliance with their care / treatment plan and to ensure continuity of care
  • Identifies barriers to optimal care and outcomes or clinical concerns and communicate with members and providers to formulate action plan to address
  • Documents all care coordination activities and interventions in the member’s health plan clinical record
  • Maintains a focus on timely, high-quality customer service
  • Maintains the confidentiality of all sensitive information

Job Case Management
Primary Location US-KS-Pittsburgh
Other Location 
Organization C&S Kansas
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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