Care Coach Connect RN Case Manager

3 weeks ago

Lubbock TX, United States UnitedHealth Group Inc Full time

Care Coach Connect RN Case Manager - Lubbock, TX
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. The Care Coach Connect RN/Case Manager coordinates care and provides initial ongoing nursing assessment of the patient and family needs and coordination of the patient's plan of care with interdisciplinary team members and the Care Coach Connect supervising clinician.
The CCC RN Case Manager is responsible for performing 80% home visits and 20% telephonic case management.
Conducts medical home visits on established Care Coach Connect patients performing a hands on exam at each visit
* Conducts urgent/acute visits on established Care Coach Connect patients with the goal of keeping the patient out of the hospital in order to receive the best medical care at home
* Assess for caregiver burnout, and provide community resources when appropriate
* Implement the individualized plan of care and recommend revisions to the plan as necessary
* Wound care and dressing change b. Phlebotomy c. Ability to conduct an advanced care discussion with a patient and their family and properly document their wishes in the electronic medical record. Consults and educates the patient/family and other caregivers regarding the disease process, pain and symptom management, end of life care and processes for dealing with issues of ethical concern
* Initiates appropriate preventive and rehabilitative nursing procedures when appropriate
* Ensure continual assessment of patient and family needs from admission to Care Coach Connect throughout the course of care
* Provides ongoing evaluation of the patient and family/caregiver response to care, and recommends alteration of the plan when necessary. Decision making is usually based on prior practice or policy, with some interpretation. Applies individual reasoning to the solution of a problem devising or modifying processes and writing procedures
* Conducts telephonic nursing follow up and case management when necessary
* Attends educational offerings to keep abreast of chronic medical conditions and complies with licensing requirements
* Establishes a trusting relationship with identified patients, caregivers, clinic staff members and Providers
* Collaborates with the providers to recommend policies, procedures and standards which affect the care of the Care Coach Connect Patient
* Follows Care Coach Connect providers' orders regarding the scope and frequency of services needed based on acuity and patient/family needs
* Coordinates all patient/family services and prioritization of needs with the members of the interdisciplinary team
* Documents in the electronic health record progress toward established goals as per standards
* Uses the case management approach and refers to other services as needed
* Maintains a patient case load, daily visits and point of care documentation levels as per standards
* Performs all other related nursing duties 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.
3+ years of experience in a physician's office, clinical, hospice or hospital setting
* Proficient computer skills, including Microsoft Word, Excel, Access and Outlook
* Demonstrate experience of excellent nursing skills
* Have reliable transportation for daily travel to various locations as assigned, up to 80% of the time
* Hospice and Palliative Care Nursing certification
* 2+ years of hospice experience
* Knowledge of palliative and hospice medicine
* Experience related to advanced care planning and discussions with patients regarding end-of-life wishes
* Experience with community-based nursing
* Bilingual (English/Spanish) language proficiency
* Ability to use fine motor skills to operate office equipment and/or machinery Ability to properly drive and operate a company vehicle
* Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex problem solving
* 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. 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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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