Utilization Care Manager Jobs in Virginia (NOW HIRING)

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Role requires travel to various Nursing Facilities and Members homed. This is a Field Based role with a Home Based Office. For consideration, you must reside within the Western VA Markets

If you reside within a commutable distance of Western, VA Markets, you will have the flexibility to work remotely* as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. 

Primary Responsibilities:

• Participate in discharge planning for Members transitioning from LTC facility settings to the community
• Coordinate with Utilization Management staff, as indicated regarding discharge planning
• Collaborate and Coordinate with Nursing Facility staff, the Member's assigned care coordinator, and the Member when it is identified that the Member wishes to transition from NF care to the community
• Provide support to care coordinators to maintain Members in the community in lieu of transitioning to institutional settings, as needed
• Collaborate and partner with community resources (e.g. CILs, CSBs, AAAs, etc.) and work with staff to facilitate safe transitions for members willing and able to transition from custodial NF care back to a community setting of their choice
• Provide consistent follow up during the first year after discharge and shall make adjustments to the transition plan to assure acclimation and integration into the community as needed by the Member
• For Dual eligible members enrolled in a DSNP, the Regional Transition Coordinator shall also work with the DSNP care coordinator upon approval of the Member, to coordinate the above activities
• Review daily census, prioritizes daily work and monitor progress of transitions in accordance with Care Coordination policies
• Actively collaborate and communicate with physicians and providers to arrange appropriate follow up, discharge planning and/or alternative care and services for plan members
• Coordinate the authorization process for discharge planning needs in accordance with Plan policy and procedure
• Participate in NF ICT/ Care Team meetings as appropriate; NF Rounds, Quarterly team meetings with NF CC and other meetings as required to facilitate transitions
• Coordinate transition of members to other Level Care Coordinators as indicated

• Perform other delegated duties as assigned

***The role requires travel throughout Western VA Markets visiting Nursing Facilities as well as our members who are transitioning to new locations in that market. ***

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:

• Social Worker with BSW degree or LPN with current/unrestricted license in Virginia
• 3 years of care coordination or behavioral health experience and/or work in a healthcare environment
• 1 years of experience directly working with individuals with complex medical or behavioral needs
• Proficient computer skills in Microsoft Office to include Word, Outlook and the ability to type and talk at the same time and toggle between multiple screens 
• Demonstrate the ability to communicate with members who have complex medical needs, the elderly, individuals with physical disabilities, and/or those who may have communication barriers
• Demonstrate ability to communicate and collaborate with multiple stakeholders on the implementation the transition plan
• Driver's License and access to reliable transportation

Preferred Qualifications:

• LSW/LCSW
• Certified Case Manager 
• Experience managing transitions between care setting, including transition from nursing facility care to care in the community
• Experience providing care coordination to persons receiving long-term care and/or home and community based services
• Experience working with Medicaid/Medicare population
• Long term care/geriatric experience
• Case management experience in a clinical setting (hospital, long term care, home health, hospice) or 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 $24.00 to $43.00 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.

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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