Diagnosis Related Group (DRG) Coordinator jobs in Roswell, NM

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The RN Field Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs.  Care coordination activities focus on supporting member’s medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care.

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 8am to 5pm.  It may be necessary, given the business need, to work occasional overtime. This position is a field - based position with a home - based office. 

If you are located in the Southeast region of New Mexico or within commutable distance, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs
• Develop and implement person centered care 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 and coaching to support member self-management of care needs and lifestyle changes to promote health
• 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
• 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

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 independent licensure as a Registered Nurse, Licensed Clinical Social Worker (LCSW) or Licensed Master Social Worker (LMSW)
• 3 years of clinical experience
• 2 years of relevant health care experience
• 1 years of experience with MS Office, including Word, Excel, and Outlook
• Reliable transportation and the ability to travel within assigned territory to meet with members and providers
• Currently reside in New Mexico
• Willing or ability to travel locally up to 50% of the time

Preferred Qualifications:

• Master's degree or Higher in clinical field
• Commission for Case Manager (CCM) certification
• 3 years clinical experience as a Registered Nurse
• 1 years of community case management experience coordinating care for individuals with complex needs
• Experience working in team-based care
• Background in Managed Care

*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.