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Nurse Case Manager

1 month ago

SAN ANTONIO, United States Optum Full time
p>Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. p>The primary responsibility of the Case Manager is to identify, screen, track, monitor and coordinate the care of members with multiple co-morbidities and/or psychosocial needs and develop a case management care plan. They will interact and collaborate with interdisciplinary care team (IDT), which includes physicians, inpatient case managers, care team associates, pharmacists, social workers,  educators, health care coordinators/managers. The Case Manager also acts as an advocate for members and their families linking them to other IDT members to help them gain knowledge of their disease process(s)and to identify community resources for maximum level of independence. The Case Manager will participate in IDT conferences to review care plan and member progress on identified goals and interventions. li>In consultation with manager of Care Management, conducts initial assessments within designated time frames for members identified as having complex case management needs (assessment areas include clinical, behavioral, social, environment and financial) In consultation with manager of Care Management collaborates effectively with IDT to establish an individualized care plan for members with interventions to assist the member in meeting short and long term goals Engage patient, family, and caregivers to assure that a well-coordinated care plan is established Will identify member needs, develop care plan and prioritize goals; using evidence based practice the Case Manager will develop interventions while considering member barriers with guidance from medical directors and Manager of Care Management Make outbound calls to assess member health status, identify gaps or barriers in care plan Educate members on disease process or acute condition and provide indicated contingency plan with guidance from medical directors and Manager of Care Management Coordinates visits with PCP and specialists on a limited basis, performs visual assessment for skin checks on exposed skin, and conducts home safety evaluation Enters timely and accurate data into designated care management applications and maintains audit scores of 90% or better on a monthly basis Adheres to organizational and departmental policies and procedures Proven ability to read, analyze, interpret information in medical records and health plan documents
Proven ability to problem solve and identify community resources Proven planning, organizing, conflict resolution, negotiating and interpersonal skills Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area  This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor‘s diagnosis of disease 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: 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.