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The HSS Clinical Coordinator will provide medically oriented clinical consults/guidance within the team and to other area within the health plan. HSS Clinical Coordinator will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. HSS Clinical Coordinator will coordinate activities 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.
Together, we're removing the barriers that keep people from receiving the kind of quality healthcare that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well - being.
Schedule : Schedule is Monday through Friday between the hours of 8 am to 5pm.
If you reside in Michigan, you will enjoy the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:
Serves as primary care manager for members with primary high behavioral needs members
Engage members through a variety of modalities (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 psychoeducation 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
Performs other duties as assigned
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:
Master's degree in Social Work or in another behavioral health related field (e.g., psychology, counseling, etc.) OR 5+ years of experience as a Licensed Social worker
Current, unrestricted license in designated field (e.g., LCSW/LISW, LPC, LMFT)
2+ years of experience working with diverse multi-ethnic/socioeconomic populations and a myriad of psychological disorders and addictions
2+ years of experience serving Medicaid populations
1+ years of community outreach/field work experience in a healthcare setting
1+ years of experience with knowledge of state-specific behavioral health Medicaid benefits and accessing care for Medicaid recipients
1+ years of experience with knowledge of 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.)
Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
Must reside within the state of Michigan
Preferred Qualifications:
Ability to work within a matrix environment where team members are engaged in the success of the team as indirect reports but have a direct reporting relationship to others
Demonstrated experience / additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care
Experience with electronic charting
Intermediate computer proficiency including MS Word, Excel, and Outlook
Experience working in Managed Care
Background in managing populations with complex medical and behavioral needs,
Work at home experience
Soft Skills:
Strong communication and customer service skills both in person and via phone
Ability to work independently and maintain good judgment and accountability
Demonstrated ability to work well with others
Strong organizational and time management skills
Ability to multi-task and prioritize tasks to meet all deadlines
Ability to work well under pressure in a fast-paced environment
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
*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
