RN Case Manager

4 weeks ago

Greensboro, North Carolina, United States UnitedHealth Group Full time
Job Title: RN Case Manager

Optum Home and Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere.

Job Summary:

We are seeking a skilled RN Case Manager to join our team. As a RN Case Manager, you will function as part of the primary care team, and report to the Clinical Services Manager (CSM). This role works in close collaboration with all of the interdisciplinary team members and may support multiple providers. This role requires face-to-face interaction with members in nursing home facilities.

Responsibilities:
  • Assist the provider/team with various care coordination activities in the nursing home
  • Assist the provider/team with benefit determination associated with Medicare part A, part B, and part D benefits
  • Collaborating with the primary APC and nursing facility to identify and respond to patient Change in Condition
  • May assist the provider by completing DSTs, re-assessing the patient, and other activities as delegated by the provider or the CSM
  • Assist the provider/team with therapy coordination for members including possible assessments or follow up on requests and communicate and collaborate with APC
  • May perform interval check in on patient progress with therapy department
  • May participate in facility-based therapy discussion meetings
  • Schedule and participate in family conferences, team meetings, and team case presentations
  • May assist in the coordination of training, tracking and compliance with quality measures
  • Participate in facility partnership or Customer Relationship Management (CRM) meetings under the direction of the APC / CSM
  • May assist in coordinating CRM meetings, and may participate in and contribute to the meetings
  • May assist the team in tracking LearnSource completion for the team members and CSM
  • Assist in creating and conduct in-services for selected audiences
  • Will document information and activities in the EMR
  • May assist Providers in assuring complete and accurate documentation and coding, medication reconciliation, nursing rounds, assessment, and patient documentation
  • Assist the team/providers in prioritizing advance Care Planning and initiating discussions
  • Collaborates with all key stakeholders, providers, nursing homes, PCPs, families, interdisciplinary care teams and any other identified stakeholders
  • Review the chart and enter HEDIS / Quality information into the EMR, communicate gaps to the Provider
  • May write verbal orders from Provider in the chart in compliance with the state RN practice laws, and in compliance with individual nursing facility practices
Requirements:
  • Current, unrestricted RN license in the state of North Carolina
  • 1+ years of experience with using an Electronic Medical Record
  • Valid Driver's License with access to reliable transportation
  • Ability to be in Greensboro, NC / Guilford County going into facilities 100% of the time
Preferred Qualifications:
  • 1+ years of experience in post-acute care, such as long-term care or critical care
  • 1+ years of experience working with the geriatric population
  • Proven ability to work with diverse care teams in a variety of settings
  • Proven effective communication skills and time management

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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