Inpatient Care Coordination Specialist
2 weeks ago
About UnitedHealth Group: UnitedHealth Group is at the forefront of transforming health care by integrating leading solutions to meet the comprehensive needs of individuals. Our focus is on enhancing patient experiences by ensuring seamless transitions across various care settings.
Role Overview: The Inpatient Care Coordination Specialist plays a vital role in facilitating optimal recovery for patients. This position involves visiting skilled nursing facilities to conduct regular functional evaluations and collaborating with the interdisciplinary care team to coordinate discharge planning effectively. Engaging with patients and their families is essential to provide information and support informed decision-making. The Specialist acts as a crucial link between patients and healthcare professionals, ensuring smooth and efficient transitions of care.
Key Responsibilities:
- Serve as the primary connection between patients and healthcare personnel to ensure timely and effective transitions of care.
- Conduct assessments at Skilled Nursing Facilities (SNFs) utilizing clinical expertise and CMS criteria upon patient admission and throughout their stay.
- Collaborate with healthcare providers and families to review Length of Stay (LOS) targets, outcomes, and discharge plans.
- Complete concurrent reviews for SNFs, ensuring timely updates to authorizations.
- Work closely with the patient's healthcare team, including physicians, discharge planners, and therapists, to facilitate optimal discharge planning.
- Monitor patient progress towards discharge goals and assist in overcoming any barriers.
- Participate in weekly SNF rounds, providing accurate updates to management.
- Ensure appropriate referrals are made to health plans and community services as needed.
- Engage with patients and families through regular communication, both on-site and via phone.
- Attend care conferences to discuss patient needs and progress.
- Assess patients' ongoing suitability for SNF placement according to CMS guidelines.
- Manage a caseload efficiently, utilizing strong time management skills.
- Maintain accurate documentation in the care coordination system.
- Review monthly performance reports with management to identify areas for improvement.
- Adhere to all regulatory policies and maintain confidentiality of patient information.
Qualifications:
- Active and unrestricted clinical license as a Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Therapist.
- A minimum of 3 years of clinical experience in a relevant field.
- Proficiency in Microsoft Office applications.
- Reliable transportation for travel to various facilities.
- A dedicated workspace at home for remote work.
- Access to high-speed internet.
Preferred Qualifications:
- Knowledge of CMS, Medicare, and Medicaid regulations.
- Experience in case management and working with geriatric populations.
- Background in patient education, rehabilitation, or home health.
- Strong communication and problem-solving skills.
- Ability to manage multiple tasks effectively and independently.
At UnitedHealth Group, we are committed to fostering a diverse and inclusive workplace. We believe in providing equitable care and addressing health disparities to improve outcomes for all individuals.
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