RN Case Manager Long Term Care - West Virginia

Company: UnitedHealth Group
Location: Charleston
Posted on: January 7, 2021

Job 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 and help people live healthier lives while doing your life's best work.(sm)As a Long-term Care 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 Senior Case Manager is a flexible team member who works under the direction of the Advanced Practice Clinician (APC) and activities are delegated to the Senior Case Manager by the APC or the team Clinical Services Manager (CSM).Primary 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
• Responsible for collaborating with the primary APC and nursing facility to identify and respond to patient Change in Condition
• May assist the provider by completing DSTs, re - assessing the patient, and other activities as delegated by the provider or the CSM
• Assist the provider / team with therapy coordination for members including possible assessments or follow up on requests and communicate and collaborate with APC
• May perform interval check in on patient progress with therapy department
• May participate in facility based therapy discussion meetings
• Schedule and participate in family conferences, team meetings, and team case presentations
• May assist in the coordination of training, tracking and compliance with quality measures
• May 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
• May assist in coordinating CRM meetings, and may participate in and contribute to the meetings
• May assist the team in tracking LearnSource completion for the team members and CSM
• Assist in creating and conduct in - services for selected audiences
• Will document information and activities in the EMR
• May 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
• Collaborates 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 EMR, communicate gaps to the Provider
• May write verbal orders from Provider in the chart in compliance with the state RN practice laws, and in compliance with individual nursing facility practicesYou'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:
  • Current unrestricted Registered Nurse license in the state of West Virginia
  • 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 an Electronic Medical Record
  • Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area
  • You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role.
  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attainedPreferred Qualifications:
    • Bachelors degree
    • Familiarity with Medicare part A, part B, and part D benefits
    • Familiarity with the long term care business environment
    • Basic Microsoft Office skills with the ability to navigate in a Window's environment
    • Previous experience conducting in - servicesCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.Job Keywords: CCM, RN, Charleston, Beckley, WV, West Virginia

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