RN Case Manager

3 days ago

Gastonia, United States UnitedHealth Group Full time
Optum Home & Community Care: A New Era in Healthcare

We are revolutionizing the healthcare industry by uniting industry-leading solutions to build an integrated care model that addresses an individual's physical, mental, and social needs. Our goal is to provide seamless access to care, anytime and anywhere.

As a team member of our Senior Community Care (SCC) product, you will work closely with a collaborative team to provide care to patients at home, in nursing homes, and assisted living facilities. This life-changing work adds a layer of support to improve access to care, connecting care to create a seamless health journey for patients across care settings.

Role and Responsibilities
  • Function as part of the primary care team, reporting to the Clinical Services Manager (CSM)
  • Collaborate with all key stakeholders, providers, nursing homes, PCPs, families, and interdisciplinary care teams
  • 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
  • Collaborate 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 conducting 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
Requirements
  • Current, unrestricted RN license in the state of North Carolina
  • Valid Driver's License with access to reliable transportation
  • 1+ years of experience with using an Electronic Medical Record
  • Ability to be in Gastonia, NC 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
About UnitedHealth Group

We believe everyone – of every race, gender, sexuality, age, location, and income – deserves the opportunity to live their healthiest life. Our mission is to help people live healthier lives and make the health system work better for everyone.

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.

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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