Care Coordinator, Health - Kitsap County, WA - Remote

Position: Care Coordinator, Health Home - Kitsap County, WA - Remote At United Healthcare, 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. The Health Home Field Care Coordinator will be the primary case manager for a panel of high-cost, high-risk Medicare-Medicaid enrollees focusing on intensive care coordination services to improve health care outcomes and cost savings. Care Coordinators will integrate care for enrollees across multiple delivery systems working to reduce gaps in services and increase coordination of all service providers including medical, behavioral health, long-term services and supports, and other social services. This is achieved through using the principles of patient activation and engagement to set health action goals and increase self-management skills to achieve optimal physical and cognitive health. If you are located preferably in Kitsap County, WA, you will have the flexibility to work remotely • as you take on some tough challenges. Primary Responsibilities: • Engage members, family, and caregivers face-to-face to complete a comprehensive health needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs. • Develop and implement person centered Health Action Plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines. • Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan. • Provide education, health promotion, and coaching to support member self-management of care needs and lifestyle changes to promote health. • Provide individual and family support for members. • Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission. • Advocate for members and families as needed to ensure the member’s needs and choices are fully represented and supported by the health care team. • Research, locate and make referrals to community resources to address member specific care or socioeconomic needs. Follow up to confirm services are received. • Proactively engage the member to manage their care, provide education and coaching to support self-management of needs and health promotion as outlined in care plan. You’ll be rewarded and recognized for your performance in an environment that will #J-18808-Ljbffr Apply Job!