Field Care Coordinator, Remote in NM

About the Role

The Field Care Coordinator is responsible for managing a panel of members with low-to-medium complexity medical/behavioral needs. This full-time, field-based position with a home-based office requires flexibility to work any 8-hour shift between 8 am and 5 pm, Monday through Friday, with potential for occasional overtime. The role is remote for individuals located in the Albuquerque or Rio Rancho, NM areas.

Key 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 plans.
• 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 transitions following ER visits, inpatient, or Skilled Nursing Facility (SNF) admissions.
• Advocate for members and families to ensure their needs and choices are fully represented and supported by the health care team.
• Create a positive experience and relationship with the member.
• Practice cultural sensitivity and cultural competence in daily care.
• Learn and listen to member needs and barriers to help promote self-advocacy.
• Collaborate with the clinical team on social aspects that might impact treatment plans.
• Proactively engage members to manage their own health and healthcare.
• Assist members in engaging with mental health and substance use treatment as needed.
• Provide member education and health literacy on community resources and benefits to encourage self-sufficiency.
• Support members in engaging in work or volunteer activities, if desired, and develop solid social supports through deeper connections with friends, family, and their community.
• Partner with the care team (community, providers, internal staff).
• Maintain knowledge and continue learning of community cultures and values.
• Conduct Comprehensive Needs Assessments (CNAs).

Requirements & Tech Stack

• MS Office (Word, Excel, Outlook)
• Driver's license and access to reliable transportation
• High-speed internet availability at designated workspace

Qualifications

• Bachelor's degree OR 2+ years of relevant health care experience.
• 1+ years of experience with MS Office, including Word, Excel, and Outlook.
• Ability to travel up to 50% of the time within the NM assigned territory to meet with members and providers.
• Designated workspace inside the home.
• Must currently reside in the Albuquerque or Rio Rancho, NM areas.

Preferred Qualifications

• CCM certification
• 1+ years of community case management experience coordinating care for individuals with complex needs.
• Experience in Managed Care.
• Experience working in team-based care.

All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.