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Registered Nurse RN Healthcare Case Manager WellMed Victoria Texas
4 months ago
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 Healthcare Manager is responsible for successfully supporting patients with high risk health conditions to navigate the healthcare system. The Healthcare Manager assists in developing patient empowerment by acting as an educator, resource, and advocate for patients and their families to ensure a maximum quality of life. The Healthcare Manager interacts and collaborates with multidisciplinary care teams, to include physicians, nurses, pharmacists, laboratory technologists, social workers, and other educators. The Healthcare Manager acts as a resource for clinic staff. The Healthcare Manager works in a less structured, self-directed environment and performs all nursing duties within the scope of a RN license of the applicable state board of nursing. Primary Responsibilities: * Works with the providers and clinic staff to identify patients at high risk telephonically primarily * Supports longitudinal care of the patient with chronic care conditions by: * performing assessment of health conditions * performing medication reconciliation * conducting Motivational Interviewing and Self-Management Goal setting * providing patient education, creating referrals to appropriate agencies and resources * Supports transition of the patient with chronic care conditions from inpatient to outpatient setting, by: * performing assessment of transitional needs * performing medication reconciliation * establishing and reviewing contingency plan * providing patient education * assisting with post discharge needs such as prescriptions, transportation, Durable Medical Equipment (DME), appointments * Coordinate with providers to establish or update plan of care * Performs accurate and timely documentation in the electronic medical record * Participates in daily huddles and Patient Care Coordination (PCC) meetings * Prepares accurate and timely reports, as required, for weekly meetings * Maintains continued competence in nursing practice and knowledge of current evidence-based practices * May perform clinical tasks within their scope of practice 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: * Bachelor's degree in Nursing or Associate's degree in Nursing with four or more years of experience * Registered Nurse with an active and unrestricted license to practice in the state of employment * Current BLS certification * 2+ years of experience in a physician's office, clinical or hospital setting * Knowledge of chronic diseases, COPD / asthma, diabetes, CHF and IHD * Proficient computer skills to work efficiently with electronic medical records * 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: * BSN * Certified Case Manager (CCM) * Case management experience * Experience or exposure to discharge planning * Experience in utilization review, concurrent review or risk management * Experience in a telephonic role * Background in managed care * Bilingual English/Spanish 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.
