Care Coordinator RN
18 hours ago
At UnitedHealth Group, we're committed to simplifying the healthcare experience and creating healthier communities. As a Care Coordinator RN, you'll play a vital role in removing barriers to quality care and making a meaningful impact on the lives of millions of people.
About the Role:The Care Coordinator RN is a key member of the primary care patient-centered medical home team, working collaboratively to assess, plan, implement, coordinate, monitor, and evaluate options and services to meet a member's health needs. This role requires strong communication and problem-solving skills, as well as the ability to work effectively with various stakeholders, including providers, office staff, and members.
Key Responsibilities:- Provides patient-centered interventions, such as medication and care compliance initiatives, case management, and health coaching.
- Assesses the total individual, inclusive of medical, psychosocial, behavioral, cultural, and spiritual needs, to develop a plan of care that promotes quality outcomes.
- Interacts with the member and the multidisciplinary team to establish measurable healthcare goals and prioritization of the member's needs, monitoring adherence to the plan of care.
- Serves as a health coach to educate the member, family, and/or caregiver about disease status and treatment, plan benefits, community resources, and resource options.
- Assists members with scheduling appointments with the primary care provider (PCP), specialists', referrals, follow-up testing, and/or office procedures.
- Monitors performance against assigned member's gaps in HEDIS and Star measures through weekly report analysis and ensures receipt, review, and documentation of test and treatment results.
- Identifies, plans, and documents all follow-up to hospital treatment with the interdisciplinary team and primary care physician (PCP).
- Collaborates in efforts that focus on moving the individual to self-care when possible.
- Licensed RN or compact RN license with the ability to practice in the State of Louisiana.
- 2+ years of experience in a clinical setting.
- 2+ years of experience with clinical documentation systems.
- 2+ years of experience in assessing members and developing care plans.
- Proficient with MS Office (MS Word, Excel, and PowerPoint).
- Ability to work Monday through Friday 8am-5pm Central Standard Time hours.
- Bachelor's degree in Nursing.
- Disease management, chronic care improvement, and/or quality improvement experience in a managed care setting.
- Case management or care coordination experience.
- Experience in managed care industry setting - STAR/HEDIS experience.
- Proven understanding of HMO and third-party administration.
- Proven understanding of nursing home and long-term acute care regulations.
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.
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