Clinical Administrative Coordinator - Work from Home

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM


Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

If you are located in the Raleigh, NC, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. SM

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. The Clinical Administrative Coordinator supports the LTSS Care Management team with administrative and non-clinical duties essential for the successful delivery of a high-quality care management program. The Coordinator works collaboratively with LTSS Care Managers, provider agencies, social service program, state Medicaid representatives, and other departments within UnitedHealthcare.

This position operates remotely and will require limited travel.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of 7am - 5pm. It may be necessary, given the business need, to work occasional overtime. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Primary Responsibilities:
  • Assigns and reassigns members to appropriate Care Manager under the direction of the Care Management Supervisor
  • Monitors member list routinely to assure accurate assignment of all members
  • Tracks Nursing Facility and Inpatient census data via the Blended Census Reporting Tool (BCRT)
  • Communicates member Inpatient status to the assigned Care Manager
  • Updates Member demographic and placement changes in CM system
  • Assists with administrative/enrollment activities for special programs e.g. disease management, complex case management, behavioral health referrals
  • Manages incoming communication calls/fax/email/tasking group- members/providers
  • Assists with outgoing communication (calls/fax/email)
  • Arrange member appointments w/ Care Manager
  • Coordinate transportation for members
  • Follow-up to ensure service utilization, meeting/not meeting needs
  • Distribute service plans/plan of care, other communication to members/providers
  • Review service utilization from Electronic Visit Verification (EVV) system, identify potential concerns and communicate with the Care Manager
  • Assists with facilitating resolution for pharmacy issues
  • Completes eligibility related activities- enrollment, disenrollment, tracking Nursing Facility census, etc.
  • Posts member related documents to electronic filing system (shared drive/SharePoint)
  • Documents all member related activities in Helios/Virtual Health
  • Reminds members of need to complete Medicaid paper work to maintain eligibility
  • Utilizes plan software to generate care management reports
  • Performs other duties/projects as assigned

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:
  • High School Diploma / GED (or higher)
  • 2+ years of experience working directly with community members, health care providers, and coordinating services related to physical healthcare, behavioral healthcare, pharmacy and/or social determinants of health
  • 2+ years of experience working in electronic health systems
  • Strong knowledge of local and community-based social service organizations
  • Must reside within a commutable distance of Raleigh, NC
  • Proficiency in Microsoft Office - Microsoft Word, Microsoft Excel and Microsoft PowerPoint (ability to create, edit, sort, and send correspondences, spreadsheets, and presentations)
  • Ability to travel up to 5-10% of the time locally
  • Ability to work Monday - Friday, 8-hour shifts during core business hours of 7am - 5pm EST, with flexibility to work occasional overtime per business needs

Preferred Qualifications:
  • Bachelor's Degree (or higher) in Social Services with 3+ years case management experience (preference includes Medicaid experience, physical, or behavioral health care coordination)
  • Previous experience as an administrative care manager/coordinator in a managed health care environment

Telecommuting Requirements:
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • Must live in a location that can receive a UnitedHealth Group approved high - speed internet connection or leverage an existing high - speed internet service

Soft Skills:
  • Excellent written and verbal communication skills
  • Experience working independently, managing multiple and often competing demands
  • Experience working with multi-disciplinary clinical teams
  • Experience with collecting and analyzing data and writing reports
  • Experience working with diverse populations

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible.

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 healthcare here. We serve the healthcare 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 Healthcare, Community, and Government partners to heal healthcare 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: 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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