LVN Case Manager - Disease Management - Remote

UnitedHealth Group•Everett, WA

2d•$20 - $36•Remote

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 Associate Care Manager facilitates a team approach to ensure cost-effective delivery of quality care and services based on medical conditions and social determinants. Collaborates with members, providers and other resources to evaluate, plan, facilitate and monitor options and services required to meet an individual’s healthcare needs. Promotes member’s goals for self-management, facilitates effective health care navigation, reduces gaps in care, and provides support and community resources as needed. Ensures compliance to contractual and service standards as identified by relevant health insurance plans. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Must have a valid CA nursing license.

Requirements

Graduation from an accredited Licensed Vocational Nurse program
Active compact license in CA
2+ years of recent clinical experience working as an LVN/LPN
1+ years of care management, disease management or discharge planning experience
Access to dedicated workspace from home or an in-home office set up
Reside in a location that can receive a high-speed internet connection
All staff members are to promote a positive and productive work environment by acting maturely and responsibly, satisfactorily performing his or her job responsibilities and conducting themselves in a professional, courteous and respectful manner toward fellow employees, physicians and patients
Must hold relationships to a high standard- respectful approach to all people and interactions, listening to understand, take emotional accountability and exemplify balance of self with all interactions, be receptive to feedback and opportunities keeping an open mind towards growth
Integrates Lean principles, practices and tools to improve operational efficiency, reduce costs and increase customer satisfaction
Follows written and oral instructions and completes routine tasks independently
Completes annual compliance training on HIPAA/Privacy/Confidentiality/Non-Discrimination/Harassment/Integrity Statement and signed Agreements
Ensures confidentiality of patient information following HIPAA guidelines and company policies
Attends training to meet requirements of the job position and as needed or mandated by company policies and regulations
Has regular and predictable attendance
Working knowledge of health care delivery systems
Working knowledge of PC applications including MS Office Suite
Ability to use written and oral communication skills
Ability to read and interpret data
Skill in writing clear, grammatically correct, easy to use instructional documentation
Ability to identify learning needs, set goals and seek educational opportunities
Ability to analyze problems and formulate appropriate plans, solutions, and courses of action
Knowledge of age specific communication needs with the ability to listen actively and respond to internal and external customers in a timely, competent manner both verbally and nonverbally
Ability to work with frequent interruptions
Ability to establish and maintain cooperative working relationships with individuals at all levels of the organization and affiliates
Ability to maintain confidentiality of patient and all related entity business matters of the organization and its partners
Ability to manage detail and work with accuracy
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Responsibilities

Conducts clinical evaluation of members per regulated timelines, determining who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and gaps in care
Conducts individual interview to obtain data for focused assessment and determines individual needs and prioritizes goals
Conducts telephonic, clinic, facility, hospital or home visits as indicated for patient evaluation/engagement
Identifies barriers to care and seeks solutions with member and the care team
Participates in the development and implementation of a case management plan in collaboration with the member, caregiver(s), provider(s), and/or other appropriate healthcare professionals to address the patient’s needs and goals
Performs activities identified on the individual needs and prioritized goals to evaluate effectiveness, and to document interventions and goal achievement
Maintains member case load for regular outreach and management and closes cases per procedure.
Uses motivational interviewing to evaluate, educate, support, and motivate change during member contacts
Maintains a working knowledge of community resources
Achieves productivity and audit standards per department requirements
Serves as facilitator and resource for other members of the medical group or clinical teams
Attends departmental meetings and provides constructive recommendations for process improvement
Ability to effectively delegate action items appropriately to clinical and non-clinical staff in accordance with their role and scope of practice
Performs other duties as assigned