Care Coordinator

3 weeks ago


RICHARDSON, United States Optum Full time

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. Connecting. Growing together.   



The LVN Health Coach is responsible for successfully supporting Disease Management/Chronic Care Program requirements for medical group/health plan members. The Health Coach acts as an educator, resource, and advocate for members and their families to ensure a maximum level of independence.  The LVN Health Coach will interact and collaborate with multidisciplinary care teams, which include physicians, nurses, pharmacists, laboratory technologists, social workers, and other educators. The LVN Health Coach will assist in providing patient empowerment through the use of motivational interviewing skills, problem solving, and self-management goal setting.



Primary Responsibilities:



  • Works with the PCP and clinic staff to identify patients with high risk diagnoses such as CHF, IHD, COPD/asthma and diabetes and ensures clinical guidelines are being followed
  • Contacts and performs initial interviews with patients who are in need of health coaching programs
  • Conducts Chronic Care Model visits and reviews the patient’s informal and formal support systems, focusing on what patients want to improve and educating them about their chronic disease
  • Provide necessary coaching to reduce or eliminate behaviors that are considered high-risk
  • Identify the required goals that each patient must fulfill and advice feasible options for achieving goal
  • Ensure that patients are made aware of health issues, concerns and the way in which one could combat them
  • Must raise awareness about the different available exercises, weight loss programs and other dietary requirements necessary for a healthy lifestyle
  • Utilizes appropriate motivational interviewing techniques necessary for coaching and assisting the patient to complete a self-management goal/action plan
  • Must be able to provide a chart of habits and lifestyle changes that are imperative for the improvement of the concerned patient’s health
  • Enters timely and accurate data into the electronic medical record to communicate patient needs and to ensure complete documentation of patient visits and phone calls. Tracks self-management goal outcomes and documents in electronic medical record
  • Maintains current knowledge regarding CHF, IHD, COPD/asthma and diabetes as well as related treatments and complex medications
  • Assists, initiates referrals, and coordinates transitions of car regarding hospitalization follow-up, palliative care, hospice, etc.
  • Establishes a trusting relationship with identified patients, caregivers, clinic staff members and physicians
  • Attends educational offerings to keep abreast of change and complies with licensing requirements, ensures all patient educational materials are up-to-date, and maintains knowledge of specialty and ancillary provider contract contents, to include exclusions and contract terms
  • Conducts clinic one-on-one visits with Disease Management Chronic Care Program participants, utilizing the Chronic Care Model, to assess patient needs for DME, home health, value-added services and any other necessary resources.  Communicates these needs to the appropriate person (i.e. Social Worker, clinic staff, etc.) or addresses them per process
  • Collaborates with the nurse manager to recommend policies, procedures and standards which affect the care of the patient with high-risk chronic disease diagnoses such as CHF, IHD, COPD/asthma and diabetes
  • Performs all other related duties as assigned. i.e. IV Insertion with hydration fluid administration, wound care, dressing changes, suture removal, insertion and removal of urinary catheters, and etc.


This is a clinic base position located in Richardson, TX.



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 or GED
  • Licensed Vocational Nurse with a current license to practice in the state of employment
  • 2+ years experience in a physician’s office, clinical or hospital setting
  • Cardiac, medical-surgical and/or critical care experience
  • Experience related to patient education and/or motivational interviewing skills and self-management goal setting
  • Proficient knowledge of chronic diseases, especially COPD/asthma, diabetes, CHF and IHD
  • Proficient computer skills, including Microsoft Word, Excel, Access and Outlook
  • Proven excellent verbal and written skills
  • Proven ability to interact productively with individuals and with multidisciplinary teams
  • Proven excellent organizational and prioritization skills
  • 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 


Preferred Qualifications:



  • 5+ years of experience in a physician’s office, clinical or hospital setting
  • Knowledge of managed care, referral processes, claims and ICD-9 and CPT coding


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. 


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