Manager Jobs

About The Position

Requirements

• Graduation from an accredited school of nursing
• Active, unrestricted Registered Nurse license through the State of California
• 1+ years of experience in a clinical setting or care Management
• Intermediate level experience in Microsoft products including word, excel, and outlook
• Ability to work PST business hours
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
• Candidates are required to pass a drug test before beginning employment.

Nice To Haves

• Bachelor of Science in Nursing, BSN
• Telehealth certification
• 3+ years of experience working in acute care
• 1+ years of care management, utilization review or discharge planning experience
• HMO experience
• Ability to type 45 wpm

Responsibilities

• Completing telephonic comprehensive nursing assessments
• Creating care plans
• Participating in interdisciplinary team meetings
• Evaluating patient care needs
• Coordinating care and benefits
• Delegating tasks as needed to professionals and para-professional employees
• Coordinating activities and working closely with clinicians and staff to maintain efficient department functions and ensure the successful operation of the department
• Performing operational duties as required under the supervision of the site administrator or designee
• Meeting telephonically with patients, patients' families, and caregivers as needed to discuss care and treatment plan
• Outreaching patients after a hospital discharge to ensure post discharge needs are met
• Consulting with the physician and other team members to ensure that the care plan is successfully implemented
• Using protocols and pathways in line with established disease management and care management programs to optimize clinical outcomes and minimize unnecessary institutional care
• Monitoring and coaching patients using motivational interviewing techniques and behavioral change to maximize self-management
• Overseeing provisions for discharge from facilities, including follow-up appointments, home health, social services, transportation, etc., to maintain continuity of care
• Working in coordination with the care team and demonstrating accountability with patient management and outcome
• Discussing Durable Power of Attorney (DPOA) and advanced directive status with patient and PCP when applicable
• Maintaining effective communication with the physicians, hospitalists, extended care facilities, patients and families
• Providing accurate information to patients and families regarding resources available to them through health plan benefits, community resources, and referrals
• Participating actively in Monthly Care Management Department meetings and daily huddles
• Documenting pertinent patient information and Care Management Plan in Electronic Health Record
• Coordinating care with central departments on assigned patient caseload, including inpatient, long-term care facilities, adult family homes, and home health agencies
• Demonstrating a thorough understanding of the cost consequences resulting from Care Management decisions through utilization reports and systems such as Health Plan Benefits, CM dashboards and reports
• Maintaining concise and accurate documentation that supports effective and efficient management of care plans to decrease Emergency and hospital readmissions
• Adhering to departmental policies and procedures
• Using, protecting, and disclosing HCP patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Participating in training all new care managers

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution