Optum Home & Community Care
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.
Why naviHealth?
At naviHealth, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. naviHealth is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company's technical vision and strategy.
Care Coordinator- Onsite
The Care Coordinator- Onsite plays an integral role in optimizing patients' recovery journeys. The Care Coordinator- Onsite completes weekly functional assessments and engages the post-acute care (PAC) inter-disciplinary care team to coordinate discharge planning to support the member's PAC journey. The position engages patients and families to share information and facilitate informed decisions. By serving as the link between patients and the appropriate health care personnel, the Clinical Review Coordinator- Onsite is responsible for ensuring efficient, smooth, and prompt transitions of care.
Primary Responsibilities
By serving as the link between patients and the appropriate health care personnel, the Care Coordinator- Onsite is responsible for ensuring efficient, smooth, and prompt transitions of care
Perform Skilled Nursing Facility (SNF) assessments on patients using clinical skills and utilizing CMS criteria upon admission to SNF and periodically through the patient stays
Review target outcomes, and discharge plans with providers and families
Complete all SNF concurrent reviews, updating authorizations on a timely basis
Collaborate effectively with the patients' health care teams to establish an optimal discharge The health care team includes physicians, referral coordinators, discharge planners, social workers, physical therapists, etc.
Assure patients' progress toward discharge goals and assist in resolving barriers
Participate weekly in SNF Rounds providing accurate and up to date information to the H&C Transitions Sr. Manager or Medical Director
Assure appropriate referrals are made to the Health Plan, High-Risk Case Manager, and/or community-based services
Engage with patients, families, or caregivers either telephonically or on-site weekly and as needed
Attend patient/family care conferences
Assess and monitor patients' continued appropriateness for SNF setting (as indicated) according to CMS criteria
When H&C Transitions is delegated for utilization management, review referral requests that cannot be approved for continued stay and are forward to licensed physicians for review and issuance of the NOMNC when appropriate
Coordinate peer to peer reviews with H&C Transitions Medical Directors
Support new delegated contract start-up to ensure experienced staff work with new contracts
Manage assigned caseload in an efficiently and effectively utilizing time management skills
Enter timely and accurate documentation into coordinate
Daily review of census and identification of barriers to managing independent workload and ability to assist others
Review monthly dashboards, readmission reports, quarterly, and other reports with the assigned Clinical Team Manager, as needed, to assist with the identification of opportunities for improvement
Adhere to organizational and departmental policies and procedures
Maintain confidentiality of all PHI information in compliance with HIPPA, federal and state regulations, and laws
Complete cross-training and maintain knowledge of multiple contracts/clients to support coverage needs across the business
Keep current on federal and state regulatory policies related to utilization management and care coordination (CMS guidelines, Health Plan policies, and benefits)
Adhere to all local, state, and federal regulatory policies and procedures
Promote a positive attitude and work environment
Attend H&C Transitions meetings as requested
Hold patients' protected health information confidential as required by applicable laws, regulations, or agency/institution procedures
Perform other duties and responsibilities as required, assigned, or requested
Qualifications - External
Active, unrestricted registered clinical license required in state of hire - Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Language Pathologist
5+ years of clinical experience
Ability to support specific location(s) for on-site facility needs within 30-miles maximum radius of home location based on manager discretion
Reside within or near St. George, UT
Driver's License and access to reliable transportation
Preferred Qualifications
Demonstrated familiarity with care management, utilization/resource management processes and disease management programs
Proficient with Microsoft Office applications including Outlook, Excel and PowerPoint
Experience working with the geriatric population
Proven patient education background, rehabilitation, and/or home health nursing experience
Ability to be detail-oriented
Ability to prioritize, plan, and handle multiple tasks/demands simultaneously
Ability to be a team player
Proven exceptional verbal and written interpersonal and communication skills
Proven solid problem solving, conflict resolution, and negotiating skills
Proven independent problem identification/resolution and decision-making skills
Locations
Washington UT Ivins UT Santa Clara UT Atkinville UT Harrisburg UT Leeds UT Toquerville UT La Verkin UT Hurricane UT
Hourly Range
$34.42 to $67.60 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
Equal Employment Opportunity
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
Drug-Free Workplace
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.