What are the responsibilities and job description for the Restricted Recipient Program - Clinical Coordinator - Remote in MN Only position at UnitedHealth Group?
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 Minnesota Restricted Recipient Program (MRRP) is authorized by federal regulations and was developed to improve safety and the quality of care, as well as reduce costs for Minnesota Health Care Programs recipients who have misused or abused health care services. The Restricted Recipient Program – Clinical Coordinator is responsible for reviewing and monitoring clinical information that would necessitate enrollment in the program, along with providing follow-up education around appropriate use of health care services and support in connecting with a primary care team. For members enrolled in the program, the Clinical Coordinator provides care coordination, monitors utilization, and provides education and support. This includes coordination of health care services with the designated primary care provider, clinic, hospital, and pharmacy according to contracts and program requirements. The person in this role, in collaboration with leadership and their colleagues, will also implement appropriate clinical models, resources, processes, and support for members enrolled.
If you are located in the state of MN, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities* Provides care coordination involving daily communication with members, providers, clinics, pharmacies, and hospitals
* Focuses on health equity and reducing health disparities within the healthcare system
* Ensures business processes are followed to monitor and manage RRP operational processes as defined by the state contract and / or national standardized model components
* Assists with development of policy, procedure, standard operating procedure, workflow, job aides, training materials for RRP and other related health plan initiatives
* Supports RRP or other clinical project/program workplans to achieve objectives
* Participates in cross-functional and / or cross-segment teams
* Predicts emerging customer needs and develops innovative solutions to meet them
* Participates in the development of business strategy and assists with mandated reporting needs
* Translates highly complex concepts in ways that can be understood by a variety of audiences
* Collaborates with internal and external teams to provide effective care coordination
This is position is an individual contributor role with no direct reports.
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:
* Current, unrestricted license in the State of MN in one of the following areas: Registered Nurse (RN), Licensed Independent Clinical Social Worker (master’s level LICSW), Licensed Alcohol and Drug Counselor (LADC)
* 1 year of experience working in clinical settings with a medical understanding of prescription drugs, clinical documentation, a broad range of acute and chronic conditions which require medical intervention and services
* 1 year of experience working with Medicaid services
* Proven ability to interpret, organize and apply regulations
* Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
* Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Preferred Qualifications:
* Master’s degree
* 2 years of experience working a healthcare setting, prior behavioral health experience
* Minnesota Restricted Recipient Program experience
* Managed Care Organization experience
* Experience identifying patterns of abuse of health care services
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
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)
•All employees working remotely 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.
The Minnesota Restricted Recipient Program (MRRP) is authorized by federal regulations and was developed to improve safety and the quality of care, as well as reduce costs for Minnesota Health Care Programs recipients who have misused or abused health care services. The Restricted Recipient Program – Clinical Coordinator is responsible for reviewing and monitoring clinical information that would necessitate enrollment in the program, along with providing follow-up education around appropriate use of health care services and support in connecting with a primary care team. For members enrolled in the program, the Clinical Coordinator provides care coordination, monitors utilization, and provides education and support. This includes coordination of health care services with the designated primary care provider, clinic, hospital, and pharmacy according to contracts and program requirements. The person in this role, in collaboration with leadership and their colleagues, will also implement appropriate clinical models, resources, processes, and support for members enrolled.
If you are located in the state of MN, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities* Provides care coordination involving daily communication with members, providers, clinics, pharmacies, and hospitals
* Focuses on health equity and reducing health disparities within the healthcare system
* Ensures business processes are followed to monitor and manage RRP operational processes as defined by the state contract and / or national standardized model components
* Assists with development of policy, procedure, standard operating procedure, workflow, job aides, training materials for RRP and other related health plan initiatives
* Supports RRP or other clinical project/program workplans to achieve objectives
* Participates in cross-functional and / or cross-segment teams
* Predicts emerging customer needs and develops innovative solutions to meet them
* Participates in the development of business strategy and assists with mandated reporting needs
* Translates highly complex concepts in ways that can be understood by a variety of audiences
* Collaborates with internal and external teams to provide effective care coordination
This is position is an individual contributor role with no direct reports.
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:
* Current, unrestricted license in the State of MN in one of the following areas: Registered Nurse (RN), Licensed Independent Clinical Social Worker (master’s level LICSW), Licensed Alcohol and Drug Counselor (LADC)
* 1 year of experience working in clinical settings with a medical understanding of prescription drugs, clinical documentation, a broad range of acute and chronic conditions which require medical intervention and services
* 1 year of experience working with Medicaid services
* Proven ability to interpret, organize and apply regulations
* Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
* Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Preferred Qualifications:
* Master’s degree
* 2 years of experience working a healthcare setting, prior behavioral health experience
* Minnesota Restricted Recipient Program experience
* Managed Care Organization experience
* Experience identifying patterns of abuse of health care services
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
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)
•All employees working remotely 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.
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