Vacancy expired!
Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)Primary Responsibilities:
Possess planning, organizing, conflict resolution, negotiating, collaborative and interpersonal skills to be used telephonically
Performs telephonic member evaluations to establish educational and care management needs and provide effective educational techniques
Remains knowledgeable about related high-risk diagnoses such as Diabetes, CHF, IHD, and COPD/Asthma
Assist in providing patient empowerment through use of motivation, supportive skills, problem solving, and self-management goal setting
Collaborates with interdisciplinary care team including physicians, nurses, case managers (i.e., UM inpatient case managers), social workers and other educators/health coaches to identify and provide effective education techniques for plan member
Evaluates effectiveness of teaching methods and provides feedback, recommendations and corrective action plans to the multidisciplinary care team for ensure patient progression toward goals
Provide member enrollment into qualifying programs such as, but not limited to: Medication Voucher Programs, Diabetic supplies, Diabetic shoes
Ensures all new initiatives, policies and procedures, guidelines or other necessary updates are incorporated into patient educational program to provide reconciliation and/or verification of status, conditions and/or medications
Manages patient case load in an efficient and effective manner utilizing time management skills to facilitate the total work process managing assigned caseload
Provides constructive information to minimize problems and increase customer satisfaction
Seeks ways to improve job efficiency and makes appropriate suggestions following the appropriate chain of command
Enters timely and accurate data into designated care management applications following CMS and/or health plan requirements (i.e., NCQA or URAC guidelines) for care management documentation as needed to communicate patient needs
Follows plan for professional development and actively seeks out opportunities to increase knowledge and expertise in nursing education
Maintains knowledge of health plan benefits and provider network
Participates in the development of appropriate QI processes, establishing and monitoring indicators
Performs all duties for internal and external customers in a timely and responsible manner representing the company with the utmost professionalism
Performs all other related duties as assigned
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:
Minimum Required Education, Experience & Skills
Graduate of a Licensed Practical Nursing Program with a current license to
practice in the applicable state
Diverse clinical experience with two or more years experience in caring for the acutely ill patients with multiple disease conditions
Possess planning, organizing, conflict resolution, negotiating and interpersonal skills
Proficient in PC software computer skills such as Microsoft Word, Excel, Power Point, and other departmental specific programs/applications
Independent problem identification/resolution and decision making skills
Must be able to prioritize, plan, and handle multiple tasks, demands simultaneously
Preferred Qualifications:
Experience working with psychiatric and geriatric patient populations
5 or more years experience in caring for the acutely ill patients with multiple disease conditions Bilingual (English/Spanish) language proficiency
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 380,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.Job Keywords: Case Manager, LPN, Telephonic Case Management, Home Health
