Care Coordinator - Onsite - Independence MO (Hybrid - RN/PT/OT/ST)

UnitedHealth Group Inc.•Independence, MO

58d•Hybrid

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 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 members 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.

Requirements

Active, unrestricted registered clinical license in state of hire - Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Language Pathologist
Candidate hired will support specific location(s) for on-site facility needs within 30-miles maximum radius of home location based on manager discretion
5+ years of clinical experience
Reside within or near the county listed on the job description
Driver's license and access to reliable transportation

Nice To Haves

Experience working with the geriatric population
Familiarity with care management, utilization/resource management processes and disease management programs
Proficient with Microsoft Office applications including Outlook, Excel and PowerPoint
Patient education background, rehabilitation, and/or home health nursing experience
Detail-oriented
Ability to prioritize, plan, and handle multiple tasks/demands simultaneously
Team player
Exceptional verbal and written interpersonal and communication skills
Solid problem solving, conflict resolution, and negotiating skills
Independent problem identification/resolution and decision-making skills

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