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Licensed Vocational Nurse Care Coordinator

2 months ago

Arcadia, California, United States UnitedHealth Group Full time

For those aspiring to shape the future of healthcare, this is your chance. We are advancing beyond conventional care to health initiatives that are seamlessly integrated across the entire spectrum of services. Join us to embark on Caring. Connecting. Growing together.

At UnitedHealth Group, we are transforming healthcare with a commitment to health equity, affordability, quality, and convenience. We are dedicated to assisting millions of patients in leading healthier lives and enhancing the efficiency of the healthcare system for everyone. Our culture is rooted in compassion for our team members, patients, and communities. Become a part of our mission to make a meaningful and enduring impact on healthcare.

Under the supervision of a Registered Nurse, you will play a crucial role in ensuring continuity of care in both inpatient and outpatient environments, utilizing the necessary resources within the framework of established contracts and patients' health plan benefits. You will facilitate a seamless continuum of patient care by applying your nursing knowledge, experience, and skills to ensure optimal resource utilization and patient outcomes. You will conduct care management functions either on-site or via telecommunication as required, and promptly report your findings to the Care Management department Supervisor / Manager / Director.

Key Responsibilities:

  • Consistently demonstrate behavior and communication skills that reflect UnitedHealth Group's commitment to exceptional customer service, including quality, care, and concern for every internal and external customer.
  • Implement current policies and procedures established by the Care Management department.
  • Conduct on-site or telephonic reviews of active patient care, including prospective, concurrent, and retrospective assessments.
  • Review patients' clinical records of acute inpatient assignments within 24 hours of notification.
  • Examine patients' clinical records within 48 hours of skilled nursing facility admission.
  • Assess patient referrals within the designated care management policy timeframe.
  • Coordinate treatment plans and discharge expectations, discussing DPA and DNR status with the attending physician when applicable.
  • Prioritize patient care needs, engaging with patients, their families, and caregivers to discuss care and treatment plans.
  • Act as a liaison for patient care and initiate pre-admission discharge planning by screening for high-risk patients or those requiring additional support.
  • Identify and assist with follow-up for high-risk patients in various care settings, collaborating with physicians and team members to ensure effective implementation of care plans.
  • Coordinate discharge provisions from facilities, including follow-up appointments, home health services, social services, and transportation to maintain continuity of care.
  • Communicate authorization or denial of services to relevant parties, including patients, attending/referring physicians, and facility administration.
  • Participate in all assigned Care Management Committee meetings and report on patient status as defined by the region.
  • Demonstrate a comprehensive understanding of the financial implications of care management decisions using relevant reports.
  • Ensure appropriate utilization of medical facilities and services within the patient's benefits and/or care management decisions.
  • Maintain effective communication with health plans, physicians, hospitals, extended care facilities, patients, and families.
  • Provide accurate information to patients and families regarding health plan benefits, community resources, specialty referrals, and related issues.
  • Initiate data entry into information systems for all patients, ensuring accurate and complete documentation of care rendered.
  • Follow patients enrolled in ambulatory care management programs to optimize clinical outcomes.
  • Utilize, protect, and disclose patients' protected health information in accordance with HIPAA standards.

In this role, you will be recognized and rewarded for your performance in an environment that will challenge you and provide clear direction for success, along with opportunities for development in other roles you may wish to pursue.

Required Qualifications:

  • Graduation from an accredited Licensed Vocational Nurse program.
  • Current LVN license in California.
  • 1+ years of recent clinical experience as an LVN/LPN.

Preferred Qualifications:

  • 3+ years of clinical experience as an LVN/LPN.
  • 2+ years of experience in care management, utilization review, or discharge planning.
  • Experience in a managed care environment.

California Residents Only: The hourly range for this role is $19.47 to $38.08 per hour, based on various factors including local labor markets, education, work experience, and certifications. UnitedHealth Group adheres to all minimum wage laws. In addition to your salary, we offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contributions, all subject to eligibility requirements.

At UnitedHealth Group, our mission is to help individuals lead healthier lives and improve the healthcare system for everyone. We believe that everyone deserves the opportunity to live their healthiest life, regardless of race, gender, sexuality, age, location, or income. We are committed to addressing health disparities and enhancing health outcomes.

Diversity fosters a healthier environment: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to any characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test prior to employment.