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 to start   Caring. Connecting. Growing together. 

  Position in this function supports corporate objectives by utilizing a demonstrated competency of Long Term Services and Supports to serve as the liaison between the RMHP, the RAE, Medical Assistance Site/County Eligibility, and CCBs. Provides Case Management services as needed. Participates in case conferences with the Supervisor. This position is designated as Key Personnel in the contract.

  Expect to spend about 50-75% of your time in assigned territory visiting our members in their homes or in long-term care facilities. You’ll need to be flexible, adaptable and, above all, patient in all types of situations.   Target territory would be   the following Colorado counties: Grand, Jackson, Rio Blanco, Moffat, or Routt Counties

Primary Responsibilities:

• Serves as the liaison between the RAE, the Medical Assistance Site/County Eligibility functions, CCBs and the CMA. Collaborates with stakeholders; ensuring collaboration with all county and Medical Assistance sites pertaining to application, renewal, case changes or re- application status for members. Ensures proper follow-up and communication to support members in obtaining and maintaining their benefits
• Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. Maintain confidentiality of patient information. The ability to maintain confidentiality is a critical and essential component of this position
• Receives referrals or shares information necessary for the CCB and/or CMA to assist individuals and members in accessing LTSS programs targeted for individuals with intellectual and developmental disabilities or children with disabilities. Coordinates care for non-waiver services for members with intellectual and developmental disabilities where applicable or appropriate and works to resolve issues to make sure members receive the services they need in the designated service area
• As needed, may provide case management services that includes intake/screening/referral, assessment/reassessment, development of support plans, on-going case management, monitoring of the Member’s health and welfare, documentation of contacts and case management activities in the Department-prescribed IMS, resource development, and case closure
• Contact the Member’s at least once within each quarterly period, or more frequently if warranted by the Member’s condition /or as determined by the rules of the LTSS Program in which the Member’s is enrolled
• Conduct face-to-face contact with the Member’s at least every six (6) months, or more frequently if warranted by the Member’s condition or the rules of the LTSS Program in which the Member is enrolled, and shall update the current approved assessment tool and Support Plan in the appropriate documentation system to reflect any changes in condition or services
• Complete a new assessment during a face-to-face reassessment annually, or more frequently if warranted by the Member’s condition or if required by the rules of the LTSS Program in which the Member is enrolled. Complete additional assessments as needed/required
• Monitor the delivery of services and supports identified within the Support Plan and the Prior Authorization Request (PAR)
• Attend Department provided training for CMA agencies as well as agency provided in-service and staff development training
• Conduct work that is in accordance with the CMA Contract Agreement’s requirements. This includes but is not limited to, providing work that is accurate, timely, and complete
• In the event, at any time throughout the case management process, the case manager suspects an individual to be a victim of mistreatment, abuse, neglect, exploitation or a harmful act, the case manager shall immediately refer the individual to the protective services section of the county department of social services of the individual's county of residence and/or the local law enforcement agency
• May take on special assignments and projects on an as needed basis. Assist with system assessment and development as needed
• This position requires travel. Requires independent, reliable, flexible, and on-demand, transportation at the incumbent’s expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage

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 meet one of the following:
  • Bachelor’s degree in one of the human behavioral science fields such as human services nursing, social work, psychology, public health
  • 5+ years of relevant experience
  • Combination of education and experience 
• 1+ years of experience with MS Office, including Word, Excel, and Outlook 
• Reliable transportation and the ability to travel up to  50-75%within assigned territory to meet with members and providers 
• Reside in Grand, Jackson, Rio Blanco, Moffat, or Routt Counties

  Preferred Qualifications:

• Experience as a caseworker or case manager with LTSS population, in a private or public social services agency may substitute for the required education on a year for year basis
• Knowledge or experience with Medicaid eligibility

Physical Requirements 

• Ability to transition from office to field locations multiple times per day 
• Ability to navigate multiple locations/terrains to visit employees, members and/or providers 
• Ability to transport equipment to and from field locations needed for visits (ex. laptop, stethoscope, etc.) 
• Ability to remain stationary for long periods of time to complete computer or tablet work duties 

Colorado Residents Only: The hourly range for this role is $23.22 to $45.43 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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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