HSS Clinical Coordinator
Southfield, MI 
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Posted 25 days ago
Job Description

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 and start doing your life's best work.SM

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:

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 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.

#RPO, #Green

 

Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Master's Degree
Required Experience
5+ years
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