UnitedHealth Group
Location
Logan, UT | United States
Job description
Optum Home & 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.
As a team member of our Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing. This life-changing work adds a layer of support to improve access to care.
We’re connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.
An RN functions as part of the primary care team, and reports to the Clinical Services Manager (CSM). The supports the APC and our members to coordinate care services. This role works in close collaboration with all of the team members, and may support multiple providers. The RN works under the direction of the provider, and activities are delegated to the RN by the provider or the team CSM. The RN understands and supports the CPM models of care Institutional Special Needs Plan (ISNP), Institutional Special Needs Plan (IESNP) and Transitions to Skilled (TTS), and works in collaboration with the team to meet the goals of the program. This role will support our members telephonically and in- person in patient settings and home settings.
Primary Responsibilities:
Establishes and maintains communication and a trusting collaborative relationship with the ICT, member/RP and primary caregiver staff in the ALC and APC
Communicates with multiple organizations operational units for seamless coordination of benefits, i.e., utilization review staff, provider relations liaison, pharmacy, etc.
Reviews member’s status and assists to achieve progress toward goals; adjusts the ICP as necessary
Performs administrative functions for or on behalf of the PCP and/or APC
Participates in program effectiveness analysis and planning
Performs member visits and rounding as established and directed by the APC
Communicates status of member with APC for evaluation and ICP updates
Communicates with member, family/RP, primary caregivers of the community and other members of the ICT with each member visit
Assists with other clinical and quality responsibilities for member, e.g., gaps in care
Attends meetings on behalf of the APC and communicates updates to the ICP with the ICT
Provides clinical educational programs for facility staff
Communicates information on behalf of the APC to the member, family/RP and primary caregiver staff at the ALC
Coordinates and collaborates with the health plan/client
Assists with ACP
Performs collection of data including functional status, BMI, vital signs, urine test for proteinuria, IFOBT specimen collection, and other clinical data. Results are entered into EMR and reviewed by APC
Performs care coordination activities within the ALC to ensure member needs are met. (i.e., member external provider appointments, therapy needs, durable medical equipment (DME) and transportation)
Stays abreast of all Model of Care (MOC) , documentation and policy updates communicated email, newsletters and team meetings
Maintains an understanding of and utilizes clinical resources independently including but not limited to Resource1, iCoreCodeGenius, Sparq, Learnsource and other optum internal sites.
Maintains confidential health information according to state and federal regulations including HIPAA
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Current unrestricted Registered Nurse license in Utah
3+ years of RN experience
1+ years of case management experience
Valid driver's license and the ability to travel locally 75% of the time
Preferred Qualifications:
BSN
Experience with using an Electronic Medical Record
Experience working in post- acute care, such as long term care or hospice and/or Case Management experience as an RN
Experience working with the geriatric population
Familiarity with the long term care business environment
Basic Microsoft Office skills with the ability to navigate in a Window's environment
Proven excellent communication and customer service skills
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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