RN or SW Field Service Coordinators - Multiple Locations, Hawaii

In this rewarding and challenging role as one of our newest Field Service Coordinators, you will be responsible for clinical operations and medical management activities across the continuum of care - from assessing and planning to implementing, coordinating, monitoring and evaluating.  This includes coordination of services, disease management, and medical management consulting.  You will also be responsible for providing health education, coaching and treatment decision support for members. Field Service Coordinators work in the community providing proactive home visits and service coordination to individuals and support to their families.

We are currently seeking Field Service Coordinators on The Big Island (Kona and Hilo), Maui and Kauai.

Primary Responsibilities:

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  Making visits to conduct face to face assessments of member needs


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  Making outbound calls to follow up on members' current health status and needs


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  Identifying gaps or barriers in care plans or service plans


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  Providing patient education to assist with self management


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  Communicate daily with members to meet state regulated guidelines


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  Documenting and tracking activities in multiple computer programs at one time


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  Interacting with Medical Directors on challenging cases


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  Coordinating services for members


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  Making referrals to outside resources


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  Coordinating services as needed (home health, DME, etc)


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  Educating members on disease processes


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  Encouraging members to make healthy lifestyle changes


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  Utilizing criteria to determine if patients are in the least restrictive environment in which they can receive services


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  Conducting post hospital assessments and adjustments to the service plan and plan of care to ensure that the discharged member receives the necessary services and resources

Required Qualifications:

• Current, unrestricted RN or Social Worker license in the State of Hawaii


• At least one (1) year of clinical or service coordination experience applicable to the managed care population


• Strong computer proficiency including the ability to type and talk at the same time and to navigate around a Windows environment


• Strong communication skills, written and verbal


• Strong organizational skills and multitasking abilities


• Must have a reliable vehicle, current and unrestricted driver's license and proof of auto insurance

Preferred Qualifications:

• Two (2) years experience in a hospital setting, acute care, home hospice, direct care experience OR experience as a telephonic Case Manager for an insurance company


• BSN


• A background in managed care


• Case Management experience is highly preferred


• Certified Case Manager (CCM)


• Experience/exposure with discharge planning


• Experience in utilization review, concurrent review and/or risk management


• Experience with home health, hospice or long term care is highly preferred


• Experience as a Public Health Nurse

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

Diversity creates a healthier atmosphere: 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.

Job Keywords: RN, Registered Nurse, Case Manager, Social Worker, LCSW, LBSW, LSW, CCM, Quest, Medicaid, Kona, Hilo, Kauai, HI, Hawaii