Senior Case Manager RN

UnitedHealth Group•Rogers, AR

10d•$85,196 - $127,794

About The Position

The Home Health Patient Care Manager is responsible for the overall supervision and coordination of clinical services. The role coordinates and supervises an interdisciplinary team to ensure continuity of high-quality care for home health patients in the team’s assigned area, in accordance with physician-prescribed plans of care and applicable state and federal laws and regulations. The position provides clinical nursing services within the scope of practice and coordinates patient referrals, clinician assignments, orders, and start-of-care visits. It also supports determination of home health benefits, medical necessity, and ongoing insurance approvals. The manager ensures patient needs are continually assessed and that individualized care is appropriate, reasonable, eligible for home health, and consistent with physician orders. Assessments and plans of care are reviewed daily according to assigned workflow, with recommendations provided to clinicians as appropriate. The role requires the ability to function in home situations without regard to a client’s age, race, creed, color, sex, disability, or financial condition.

Requirements

Current unrestricted RN licensure in the state of practice; licensure must have no restrictions.
Current driver’s license, vehicle insurance, and access to a dependable vehicle or public transportation.

Nice To Haves

Current CPR certification or ability to complete certification within 90 days of hire.
Home care experience.

Responsibilities

Provide clinical services within the scope of nursing practice, according to the plan of care and in coordination with other health care team members.
Receive referrals, ensure appropriate clinician assignments, evaluate patient orders, and schedule start-of-care visits.
Coordinate determination of patient home health benefits, medical necessity, and ongoing insurance approvals.
Ensure patient needs are continually assessed and care is individualized, appropriate, reasonable, meets home health eligibility criteria, and follows physician orders.
Review assessments and plans of care daily according to the assigned workflow, and consult clinicians with recommendations as appropriate.
Function in home situations regardless of the client’s age, race, creed, color, sex, disability, or financial condition.
Supervise and coordinate clinical services and an interdisciplinary team to support continuity of high-quality home health care.