Description
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start **Caring. Connecting. Growing together.**
You push yourself to reach higher and go further. Because for you, it's all about ensuring a positive outcome for patients. In this role, you'll work in the field and coordinate the long-term care needs for patients in the local community. And at every turn, you'll have the support of an elite and dynamic team. Join UnitedHealth Group and our family of businesses and you will use your diverse knowledge and experience to make health care work better for our patients.
The United Healthcare at Home program is a longitudinal, integrated care delivery program that coordinates the delivery and provision of clinical care of members in their place of residence. The DSNP program combines clinicians providing intensive interventions customized to the needs of each individual, in collaboration with the Interdisciplinary Care Team, which includes the clinician, the member's Primary Care Provider and other providers, and other professionals.
**Core Position Hours:** Monday - Friday, 8:00am - 5:00pm
**Primary Responsibilities:**
Assess, plan and implement care management interventions that are individualized for each patient and directed toward the most appropriate, least restrictive level of care
Conduct timely outreach and in person home visits with members who are newly eligible for EPD Waiver services and complete required assessments in the EMR
Identify and initiate referrals for both healthcare and community-based services; including but not limited to financial, psychosocial, community and state supportive services
Develop and implement care plan interventions throughout the continuum of care as a single point of contact
Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team
Identify appropriate interventions and resources to meet gaps (e. g., psychosocial, transportation, long-term care) based on specific consumer needs from both the health care and psychosocial / socioeconomic dimensions of care
Document the plan of care in appropriate EHR systems and enter data per specified
Maintain consumer engagement by establishing rapport, demonstrating empathy, and building a trusting relationship
Collaborate with primary providers or multidisciplinary team to align or integrate goals to plan of care and drive consistent coordination of care
Provide ongoing support for advanced care planning.
Reassess plan of care at appropriate intervals based on initial objectives, significant change of condition, or achievement of goals
Understand and operate effectively/efficiently within legal/regulatory requirements
Utilize evidence-based guidelines (e. g., medical necessity guidelines, practice standard)
Make outbound calls and receive inbound calls to assess members' current health status
Identify gaps or barriers in treatment plans
Provide patient education to assist with self-management
Make referrals to outside sources
Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction
Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels
This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Strong computer and software navigation skills are critical. You should also be strongly patient-focused and adaptable to changes.
**What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:**
Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
More information can be downloaded at:
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:**
Active, unrestricted Registered Nurse (RN) license
1+ years of experience working within the community health setting in a health care facility
1+ years of experience providing community-based care management to members receiving long-term care, personal care services, private duty nursing, or home health
Demonstrated competency working with Enrollees and/or families who require intensive case management services
Must live within 50 miles of the Washington D. C area
**Preferred Qualifications:**
Certified Case Manager (CCM) certification
Experience in managing populations with complex medical or behavioral needs
Experience working with Home Care Based Services and/or patients in community and home-based settings
Experience with case management, utilization review, discharge planning, concurrent review and/or risk management
Field-based work experience
Must live within 50 miles of the Washington D. C area
**Additional Considerations:**
Knowledge of and experience with D. C. community organizations that offer resources that meet the needs of Enrollees and their families
Knowledge of and experience with Medicaid LTSS and behavioral health services and service systems
Ability to travel in assigned region to visit Dual Special Needs Plan members in their homes and/or other settings, including community centers, hospitals or providers' offices
Solid computer skills including EHR documentation, MS Office, etc.
**Washington, D. C. Only:** The salary range for this role is $58,300 to $114,300 ann
Compensation Information:
$114300.0 / Yearly - $114300.0 / Yearly
Starting At: 114300.0 Yearly
Up To: 0.0 Yearly
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