Clinical Care Manager - King County, WA 2360015 | Seattle, WA | Remote

Clinical Care Manager

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

As a Clinical Care Manager working with Medicaid members, you'll wear many hats, and work in a variety of environments. You'll interact with members while incarcerated or leaving incarceration - with new medications or diagnoses. The clinical care manager's primary focus will be to provide Reentry Targeted Case Management (rTCM) services. You may also act as an intermediary between providers and members - serving in numerous roles, such as educator, evaluator, service coordinator, community resource researcher and more.

The result? Fewer hospitalizations, ER visits and costly service gaps; and a less stressful, more effective health care system for us all. This position requires clinical care coordination to be provided to Medicaid members who are currently and formerly incarcerated virtually, telephonically, or (potentially) in-person.

This position is full-time (40 hours/week) Monday to Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm.

Primary Responsibilities:

• Provide a complete continuum of quality care through close communication with members via phone interaction or in-person interaction
• Support members with condition education, medication reviews and connections to resources such as Home and Community Based Services (HCBS)
• Assist members with the transition from a carceral facility back to the community via Health Assessment and Care Planning
• Partner with care team (correctional facilities, community providers, internal staff) to complete care plans and warm handoff
• Improve health and self-management of conditions
• Reduce inappropriate emergency department utilization, preventable hospital readmissions, and reduction in recidivism
• Provide member education on Medicaid benefits, treatment options, and comprehensive services
• May participate in community events related to scope of work
• Meet NCQA Population Health Management Standards
• Meet state-specific contractual requirements related to the delivery of care management

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:

• Bachelor's degree or greater
• Current, unrestricted RN license in Washington or current, licensed behavioral health clinician (LICSW, LMHC, LMHCA, LMFTA, certified or licensed agency affiliated counselor)
• 2+ years of experience directly working with individuals with special healthcare needs
• 2+ years clinical experience in a hospital, acute care, home health/hospice, direct care or case management
• Experience with Microsoft Excel (ability to create spreadsheets, input data entry), Microsoft Word (creating and editing documents) and Microsoft Outlook (send/receive emails)
• Computer / typing proficiency to enter / retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications
• Access to high-speed internet from home
• Dedicated workspace from home
• Driver's License, access to reliable transportation, and the ability to travel up to 25% locally, to visit client and/or carceral sites within designated area
• Reside in King County, Washington

Preferred Qualifications:

• Certification in Case Management (CCM)
• Experience with members with substance use disorders and members with other complex or multiple chronic conditions
• Case Management experience
• Behavioral Health experience
• Carceral facility experience
• Medicaid, Medicare, Managed Care experience
• Home care / field-based case management
• Familiarity with the resources available in the local community

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 $40.00 to $54.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.