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Job Details
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
Position in this function 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. Function may also be responsible for providing health education, coaching and treatment decision support for members.
This is a Field-Based role with a Home-Based Office.
If you are located in or within commutable driving distance from San Erath or Comanche County, TX Markets, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
- Assesses and interprets customer needs and requirements
- Identifies solutions to non-standard requests and problems
- Solves moderately complex problems and/or conducts moderately complex analyses
- Works with minimal guidance; seeks guidance on only the most complex tasks
- Translates concepts into practice
- Provides explanations and information to others on difficult issues
- Coaches, provides feedback, and guides others
- Acts as a resource for others with less experience
- Serves as a resource to others
- Demonstrate understanding of relevant health care benefit plans
- Demonstrate knowledge of applicable area of clinical specialization
- Utilize resources to enhance professional practice and development based on learning gaps or new information. Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business results
- Identify and implement innovative approaches to the practice, in order to achieve or enhance quality outcomes and financial performance
- Use appropriate business metrics and applicable processes/tools
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:
- RN license in the state of TX
- 2+ years of clinical experience
- Knowledge of computer functionality and software applications (e.g., Excel, Word, Outlook, Power Point
- Proven work effectively in a Changing Environment
- Proven manages Time Effectively
- Proven produces High-Quality Work
- Proven works with less structured, more complex issues
- Reliable Home Internet with designated office space to ensure privacy/HIPAA compliance
- Willing to travel 75% of time
- Reside in or within a commutable driving distance from San Erath, Comanche and surrounding counties
Preferred Qualifications:
- Pediatric Experience
- Knowledge of relevant state and federal guidelines
- Proven electronic charting, accessing intranet and record management databases
- Proven bilingual Skills
*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.
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.
At UnitedHealth Group, we’re a health care and well-being company committed to helping people live healthier lives and helping make the health... Read more