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 TRICARE ECHO (Extended Healthcare Option) RN Nurse Case Manager - Phoenix, Arizona, United States

   
Job information
Posted by: UnitedHealth Group 
Hiring entity type: Insurance 
Work authorization: Existing work authorization required for United States
Position type: Direct Hire, Full-Time 
Compensation: ******
Benefits: See below
Relocation: Not specified 
Position functions: Nursing - Case Management
Nursing - Clinic RN
 
Travel: Unspecified 
Accept candidates: from anywhere 
Languages: English - Fluent
 
Minimum education: See below 
Minimum years experience: See below 
Resumes accepted in: English
Cover letter: No cover letter requested
Job code: 523144 / Latpro-2486997 
Date posted: May-21-2013
State, Zip: Arizona, 85006

Description

We have an excellent opportunity available to join our company as an ECHO (Extended Health Care Option) Nurse Case Manager providing case management services for qualified TRICARE beneficiaries requiring specialized healthcare services.  As an ECHO Nurse Case Manager, you will be responsible for providing integrated clinical case management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating care for beneficiaries with high risk diagnoses and complex needs  that may  require coordination of multiple medical and behavioral health care services.  This position provides telephonic case management support for this population.  Our mission is to help people live their lives to the fullest. Our values are Integrity, Compassion, Relationships, Innovation, and Performance.
  
Primary responsibilities include: 
  • Registering, educating and supporting the ECHO population and their families through telephonic assessment and expert clinical interventions
  • Evaluating health care needs that qualify for the ECHO benefit,  and arranging for services and  supplies to support the beneficiary’s condition
  • Collaborating with the Primary Care Provider, Specialty Care Provider, Therapists, DME provider, and other clinical service providers to enhance the quality and efficiency in healthcare delivery to the ECHO population
  • Managing the ECHO financial benefit in coordination with the beneficiary/family/Primary & Specialty Health Care Provider in order to maximize the benefit and provide enhanced quality of life
  • Document all clinical information in accordance with United Healthcare Military & Veterans policies and procedures in the member's electronic medical record
  • Assess and interprets the ECHO population’s health care needs, gaps, and requirements and provides referral to other Military and Veteran Case Management programs as indicated
  • Provides assessment, coaching, teaching  and referral to the ECHO population’s family members and caregivers as required 
  • Identifies and coordinates care with community resources as indicated
  • Identifies solutions to military unique, non-standard request and problems
  • Solves moderately complex problems and/ or conducts moderately complex analyses
  • Develops benefit focused care plan in collaboration with family, other Case Managers,  Primary Care Provider,  Specialty Providers, other service providers as needed to assure ECHO benefit managed according to DoD guidance
  • Works with minimal guidance, seeks guidance on only the most complex tasks
  • Translates concepts into practice
  • Provides explanations and information to others on difficult issues
  • Coaches, provides feedback, and guides others
  • Collaborates with specialists, physicians, and medical directors to provide the necessary care and cost efficient care for the beneficiary and family
  • Assesses the effectiveness and quality of services provided related to clinical, functional, and outcomes
  • Coordinates authorizations of services as needed (home health, DME, etc.
  • Adheres to ethical, legal/regulatory and accreditation standards




Requirements

  • Current, unrestricted RN license in state of residence
  • Prior case management program experience
  • 3+ years of experience in a hospital setting, acute care, direct care experience OR experience as a telephonic Case Manager managing complex conditions patients
  • United States citizenship
  • Ability to obtain favorable adjudication following submission of Department of Defense form SF86 NAC form SF86
  • 5+ years of case management experience STRONGLY preferred
  • Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment
  • Teamwork skills
  • Detail oriented and highly organized
  • Coaching skills
 
Additional Preferred Assets:
  • Prior telephonic Case Management experience
  • Bachelor’s Degree in Nursing or higher
  • Case management Certification (CCM)
  •  Experience managing financial benefits
  • Strong organizational skills and ability to multi-task
  • Prior military case management program experience
  • Prior experience in start-up environments
 
As a requirement of UnitedHealth Group’s contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 http://www.opm.gov/forms/pdf_fill/sf86.pdf, (the National Agency Check or “NACâ€).  Successful completion of the NAC process is a requirement for continued employment in this role.  NAC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense.  Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received.  Failure to obtain final NAC approval will result in termination from this role.
 
 
Careers at UnitedHealthcare Military & Veterans. When it comes to their health care, the men and women who help keep the peace deserve the greatest peace of mind. That’s why UnitedHealthcare is the organization that’s called on to serve them and their loved ones. We’re all about finding better ways to help improve their lives no matter where life may take them. So our career opportunities take challenge to a higher level. If you have a commitment to quality that mirrors our commitment to the men and women of the armed forces, take time to learn more about the career paths available here. It’s a genuine opportunity to do your life’s best work.
 
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
 

 

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