Field RN Case Manager Sr Community Care Pinellas County FL

UnitedHealth Group - Clearwater, FL

Full-time - Entry Level

Remote - Clearwater, FL

Insurance Carriers and Related Activities

About the position

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. As a team member of our Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing. This life-changing work adds a layer of support to improve access to care. We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together. As a Long-term Care and Assisted living Optum Registered Nurse, you will function as part of the primary care team, and report to the Clinical Services Manager (CSM). This role works in close collaboration with all of the interdisciplinary team members and may support multiple providers. The RN Case Manager is a flexible team member who works under the direction of the Advanced Practice Clinician (APC) and activities are delegated by the APC or the team Clinical Services Manager (CSM). The Optum Registered Nurse travels to visit members at skilled nursing facilities. This position will cover Pinellas County. Standard Hours: Monday - Friday 8AM - 5PM; no nights, weekends, or holidays.

Responsibilities

• Assist the provider/ team with various care coordination activities in the nursing home
• Assist the provider/ team with benefit determination associated with Medicare part A, part B, and part D benefits
• Collaborate with the primary Advanced Practice Clinician (APC) and nursing facility to identify and respond to patient Change in Condition
• Assist the provider by completing Decision Support Tool (DST), re-assessing the patient, and other activities as delegated by the provider or the Clinical Services Manager (CSM)
• Assist the provider/ team with therapy coordination for members including possible assessments or follow up on requests and communicate and collaborate with APC
• Perform interval check in on patient progress with therapy department
• Participate in facility-based therapy discussion meetings
• Schedule and participate in family conferences, team meetings, and team case presentations
• Assist in the coordination of training, tracking and compliance with quality measures
• Participate in the onboarding of new clinical staff under the direction of the CSM Manager which could include coordination of onboarding activities, and participation in other orientation activities
• Participate in facility partnership or Customer Relationship Management (CRM) meetings under the direction of the APC/CSM
• Assist in coordinating CRM meetings, and may participate in and contribute to the meetings
• Assist the team in tracking LearnSource completion for the team members and CSM
• Assist in creating and conduct in-services for selected audiences
• Document information and activities in the EMR
• Assist Providers in assuring complete and accurate documentation and coding, medication reconciliation, nursing rounds, assessment, and patient documentation
• Assist the team / providers in prioritizing advance Care Planning and initiating discussions
• Collaborate with all key stakeholders, providers, nursing homes, PCPs, families, interdisciplinary care teams and any other identified stakeholders
• Review the chart and enter HEDIS / Quality information into the Electronic Medical Record (EMR), communicate gaps to the Provider
• Write verbal orders from Provider in the chart in compliance with the state RN practice laws, and in compliance with individual nursing facility practices
• Conduct goals of care conversations
• Assist with patient care in the state of Washington, either face-to-face or telephonically

Requirements

• Associate degree or higher in Nursing (RN)
• Current unrestricted Registered Nurse license in the state of Florida
• Certified in Basic Life Support
• Valid driver's license with access to reliable transportation that will enable you to travel up to 100% to visit clients and/or patient sites within a designated area

Nice-to-haves

• For new RN graduates, proven ability to obtain an unrestricted Registered Nurse license in the state of Florida within 12 months of employment
• 1+ years of experience in post-acute care, such as long-term care
• 1+ years of experience working with the geriatric population
• 1+ years of experience with using electronic medical records
• Bilingual English/Spanish
• Proven ability to work with diverse care teams in a variety of settings
• Proven effective communication skills and time management

Benefits

• 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.)