Job Information
UnitedHealth Group Field HSS Clinical Coordinator-MMA Healthy Behaviors-Miami-Dade and Monroe, FL Counties in Coral Gables, Florida
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.
This position will be the primary care manager for a panel of members with primary complex behavioral needs. The Care Management / coordination activities will focus on supporting member’s medical, behavioral and socioeconomic needs to promote appropriate utilization of services and improved quality of care. All case management/ coordination activities will be in alignment with evidence-based guidelines. This position will liaison with the members’ provider community, including CMHCs, to help reduce fragmentation within the care ecosystem. The role will provide medically oriented clinical consults/guidance within the team and to other area within the health plan. The Behavioral Health care manager will approach their member work with an understanding of how inequities drive health disparities. They will promote health equity.
Working Schedule: Schedule is Monday through Friday between the hours of 8 am to 5 pm. This position is a field-based position with a home-based office. You will work from home when not in the field.
Locations will vary but within the following counties of Florida: Miami-Dade and Monroe Counties
This is a field-based position with a home-based office.
Local travel up to 25% and mileage is reimbursed at current government rate.
Primary Responsibilities:
Serves as primary care manager for members with primary high behavioral needs members
Engage members through a variety of modalities (face and/or telephonically) to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, socioeconomic and SDOH needs
Develops and implements individualized, person-centered care plans inclusive of goals, opportunities and interventions aligned with a person’s readiness to change to support the best health and quality of life outcomes by meeting the member where they are
Partners and collaborates with internal care team, providers and community resources/partners to leverage expertise and supports to meet needs identified in the care plan
Monitor and update care plan, incorporating feedback from member to monitor for actionable steps or indicators of progress toward care plan goals / movement through various stages of behavior change
Assist member in development of personal wellness plan / health crisis plan
Provide psycho-education regarding conditions, medications / medication adherence, provider / treatment options, healthcare system utilization
Provide coaching and supportive counseling to support:
Member self-management of care needs in alignment with evidence-based guidelines
Lifestyle changes to promote improved overall health (e.g. harm reduction strategies; behavioral change techniques)
The effective and appropriate utilization of community and natural supports
Provide referral and linkage as appropriate and accepted by member (may include internal consult opportunities such as Housing Navigator, Pharmacy Team, Peer Specialist, etc. or community-based provider referrals such as PCP, specialists, medication assisted therapy referrals, etc.)
Perform targeted activities to address HEDIS/STAR gap closure, including scheduling, reminding and verification of appointments to receive specific services
Support proactive discharge planning / collaborate with dedicated Care Transitions teams following an ER, inpatient or Skilled Nursing Facility (SNF) admission
Educate and coordinate Medicaid benefits to support care needs
Document all care management/coordination activity in clinical care management system
Coordinate care management activities in conjunction with a broader care management team to promote team-based care
Provide guidance / consultation to other team members regarding behavioral health conditions, best practice and evidence
Educate the team on the continuum of behavioral health community treatment options in support in medical-behavioral integrated care
Help identify presence or exacerbation of behavioral health symptoms that may be influencing / impacting physical health
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: http://uhg.hr/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:
MSW or Master degree in another behavioral health related field (e.g. psychology, counseling, etc.)- Current, unrestricted license in designated field (e.g. LCSW/LISW, LPC, LMFT)
BA in behavioral health field with 5+ years direct clinician experience
LPN with 5+ years direct experience serving individuals with behavioral health conditions
2+ years directly serving individuals with behavioral health conditions (mental health / substance use disorders)
2+ years serving Medicaid populations
1+ years in field-based work (face-to-face person engagement in a person’s home or other community setting)
Familiarity with state-specific behavioral health Medicaid benefits and accessing care for Medicaid recipients
Familiarity 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.)
Ability to travel 25% of time for role
Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information and live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Preferred Qualifications:
Experience in serving individuals with co-occurring disorders (both mental health and substance use disorders)
Experience working in team-based care
Demonstrated experience / additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care
Bilingual in Spanish or other language specific to market populations
Experience working in Managed Care
Lived experience (self or family) in managing or overcoming a chronic health, behavioral health or substance use condition
Soft Skills:
Possess a strong work ethic
Ability to listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner
Ability to adapt to change in the workplace
Ability to work independently and as a part of a team
Ability to interact with internal and external customers in a corporate environment
Possess a positive and motivated attitude
Willingness to adapt to multiple external environments and settings
Physical Requirements and Work Environment:
Ability to transition from office to field locations multiple times a day
Must possess transportation to visit clients in various locations
Ability to travel varied distances and multiple terrains to visit assigned client locations
Ability to carry equipment to and from field locations needed for face to face member visits (ex. laptop, stethoscope, blood pressure cuff, etc.)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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