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 Medicaid Case Manager RN - Field-based telecommuting role in Volusia County - Daytona Beach, Florida, 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
Spanish - Fluent
 
Minimum education: See below 
Minimum years experience: See below 
Resumes accepted in: English
Cover letter: No cover letter requested
Job code: 522741 / Latpro-2499397 
Date posted: Jun-06-2013
State, Zip: Florida, 32114

Description

The RN Case Manager is a field based role to support public sector population in the state of FL. Working with ages from birth to geriatric in the home and community setting concentrating on providing holistic case management services to members who are receiving or may be in need of medical daycare services or personal care assistant services. Will be traveling into member homes and medical daycare settings to conduct in depth assessments and set up plan of care.
 
Apply for this position with your eyes wide open.  Click here to view the Realistic Job Preview: UHC Community & State Field_Based_Case_Manager.pdf
 
 
***This position requires ACHA level II background checks (fingerprinting) by the state of FL for all clinicians that have face to face contact with members and will require renewal every five years.***
 
RN Case Manager Responsibilities:
  • Conduct initial and follow-up assessments within designated timeframes on patients identified as having highest risk complex case management needs (assessment areas include clinical, behavioral, social, environmental and financial)
  • Assess the patient's current medical and social circumstances to identify any gaps or barriers that would impact compliance with the prescribed treatment plan
  • Engage patient, family, caregivers, and healthcare providers to assure that a well-coordinated treatment plan is established
  • Utilize holistic approaches to patient care and integrates patient's life and motivational goals into the treatment plan
  • Prioritize care needs, set goals and develop a treatment plan (or plan of care) that also addresses gaps and/or barriers to care and uses evidence-based practice as the foundation
  • Track the patient's health status and progress in achieving clinical and personal goals
  • Initiate face to face visit and PRN calls when key gaps are identified that require additional nursing follow-up
  • Provide education, information, direction, and support related to care goals of patients
  • Coordinate acquisition and proper use of medical equipment, initially and on an ongoing basis
  • Communicate with patients, families, caregivers, physicians, and other service providers to coordinate the care needs for the patient
  • Work to facilitate patient compliance and to ensure continuity of care
  • Monitor and evaluate the patient's response to treatment(s)
  • Collaborate with the attending physicians and Medical Director to revise treatment plans as needed
  • Document assessments, interventions, and follow-up on disease management activities
  • Regularly assess the effectiveness and quality of services provided to patients by analyzing outcomes (clinical, functional, and financial)
  • Maintain a focus on timely, quality customer service
  • Provides case management and education services in the community, at a provider location or the enrollees home to address gaps in care and unmet needs
  • Maintain the confidentiality of sensitive information
  • Maintain a focus on the customer service through policy and program decisions and consider impact of these activities on the members
  • Facilitate problem resolution with members, providers, and other agencies or entities as needed

Requirements

Required Qualifications:
  • Registered Nurse (RN) with active and unrestricted license in the state of FL
  • 3+ years of clinical experience to include long-term care, home health care or acute care
  • Proficiency in software applications that include, but are not limited to, Microsoft Word and Microsoft Outlook
  • Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
Preferred Qualifications:
  • Experience providing care coordination to persons receiving long-term care and/or home and community based services
  • Experience in managed care
  • Experience working in a field based position
  • Working knowledge of Medicare/Medicaid regulations
  • Bachelors Degree or higher strongly preferred
  • Case Management Certification (CCM)
  • Bilingual - fluency in English, Spanish or Creole
 
UnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
 
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.
 
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
 
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
 
 
  
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
 
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.
.

 

UnitedHealth Group requires you to fill in their application form that will open in a different window.

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Still looking? Try our sister site DiversityJobs.com for more Daytona Beach jobs, medicaid case manager jobs or nursing jobs.

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