JOB DESCRIPTION AND DETAILS
- Make outbound calls to assess members' current health status
- 25% of the time you may be doing field work - you'll interact with members leaving the hospital - possibly with new medications or diagnoses. Or perhaps you'll perform home visits, assisting members with safe, effective transitions from care environments to where they live. You may also act as an intermediary between providers and members - serving in numerous roles, such as educator, evaluator, service coordinator, community resource researcher and more.
- Identify gaps or barriers in treatment plans
- Provide patient education to assist with self-management
- Interact with Medical Directors on challenging cases
- Coordinate care for members
- Make referrals to outside sources
- Coordinate services as needed (home health, DME, etc.)
- Educate members on disease processes
- Encourage members to make healthy lifestyle changes
- Document and track findings
- Utilize MCG criteria to determine if patients are in the correct hospital setting
- Make “welcome home” calls to ensure that discharged member receive the necessary services and resources
- Possible hospital visits with members
- Current, unrestricted RN license in the state of California
- Reside in the state of California
- 3+ years clinical experience in hospital, acute care, home health / hospice, direct care or case management
- Case Management experience
- Reliable transportation to travel to member homes or other locations within service delivery area
- Computer / typing proficiency to enter/retrieve data in electronic clinical records; experience with email, Internet research, use of online calendars and other software applications
- Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
- Ability to communicate complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
- Certification in Case Management (CCM must be obtained within 30 months of employment)
- Home care / field based case management experience
- Medi-Cal, Medicare, Managed Care experience
- Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
- Bilingual skills – Spanish, Vietnamese
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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.
Find out more...