RN Field Case Manager
4 weeks ago
We believe all patients deserve the highest level of medical care. As a member of our team, you will be part of a collaborative environment that shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff, and non-patient-facing roles, you can make a meaningful difference with us as we strive to deliver exceptional care.
Job SummaryThe Care Coach Connect RN/Case Manager coordinates care and provides ongoing nursing assessment of patient and family needs, coordinating the patient's plan of care with interdisciplinary team members and the Care Coach Connect supervising clinician.
Key Responsibilities- Conducts medical home visits on established Care Coach Connect patients, performing a hands-on exam at each visit.
- Conducts urgent/acute visits on established Care Coach Connect patients to keep them out of the hospital and receive the best medical care at home.
- Provides ongoing assessments of the impact of life-limiting and/or chronic illness(es) on the patient's physical, functional, psychosocial, and environmental needs.
- Assesses for caregiver burnout and provides community resources when appropriate.
- Implements the individualized plan of care and recommends revisions as necessary.
- Ability to perform procedures, including wound care and dressing change, phlebotomy, and injections (B12, vaccines).
- Ability to conduct an advanced care discussion with a patient and their family and properly document their wishes in the electronic medical record.
- Consults and educates the patient/family and other caregivers regarding the disease process, pain and symptom management, end-of-life care, and processes for dealing with issues of ethical concern.
- Initiates appropriate preventive and rehabilitative nursing procedures when necessary.
- Ensures continual assessment of patient and family needs from admission to Care Coach Connect throughout the course of care.
- Provides ongoing evaluation of the patient and family/caregiver response to care and recommends alteration of the plan when necessary.
- Attends the interdisciplinary meeting and is a crucial and vocal member of the team.
- Solves problems by gathering and/or reviewing facts and selecting the best solution from identified alternatives.
- Conducts telephonic nursing follow-up and case management when necessary.
- Serves as a resource or consultant for LVN/MA.
- Attends educational offerings to keep abreast of chronic medical conditions and complies with licensing requirements.
- Establishes a trusting relationship with identified patients, caregivers, clinic staff members, and Providers.
- Collaborates with Providers to recommend policies, procedures, and standards that affect the care of the Care Coach Connect Patient.
- Exhibits professionalism and is courteous with all patients, physicians, and co-workers.
- Informs the Provider of patient's needs and outcomes of interventions as per standards.
- Follows Care Coach Connect Providers' orders regarding the scope and frequency of services needed based on acuity and patient/family needs.
- Coordinates all patient/family services and prioritization of needs with the members of the interdisciplinary team.
- Documents in the electronic health record progress toward established goals as per standards.
- Uses the case management approach and refers to other services as needed.
- Maintains a patient case load, daily visits, and point of care documentation levels as per standards.
- Performs all other related nursing duties as assigned.
- Registered Nurse with a current license to practice in the state of employment (Texas).
- Current BLS certification or must obtain certification within 30 days of employment hire date.
- 3+ years of experience in a physician's office, clinical, hospice, or hospital setting.
- Demonstrated excellent nursing skills.
- Proven excellent verbal and written skills.
- Ability to interact productively with individuals and with multidisciplinary teams.
- Proficient computer skills, including Microsoft Word, Excel, Access, and Outlook.
- Excellent organizational and prioritization skills.
- Valid driver's license within the state of work.
- Access to reliable transportation for daily travel to various locations as assigned.
- 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.
- Hospice and Palliative Care Nursing certification.
- 2+ years of hospice experience.
- Experience with home visits.
- Proven knowledge of palliative and hospice medicine.
- Experience related to advanced care planning and discussions with patients regarding end-of-life wishes.
- Experience with community-based nursing.
- Bilingual (English/Spanish) language proficiency.
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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