Nurse Care Manager - North Bend, OR
Company: UnitedHealth Group
Location: Orlando
Posted on: June 25, 2022
Job Description:
Landmark Health, part of the Optum and UnitedHealth Group family
of businesses, was created to transform how healthcare is delivered
to the most medically vulnerable members in our community. Our
medical group provides home-based medical care to chronically ill
patients, many of whom are ill-equipped to navigate our
overwhelming healthcare system. Objective The Nurse Care Manager
(NCM), is an integral part of the Interdisciplinary care team
(IDT), and is responsible for the overall care management process
for high acuity engaged Landmark patients. The NCM has oversight
for developing, managing, and coordinating patients' plan of care
to include medical and psychosocial needs and patient-centered
goals. -The NCM works with patients/caregivers to maintain and
improve health status by providing care coordination, health
education, guidance and support for medical and psychosocial
complex chronic conditions. Professionals in this role elicit input
from the IDT based on initial and ongoing comprehensive assessments
of the patient. - The NCM uses nursing assessment, evaluation
skills, data and reports to guide care planning decisions for the
patient. They are skilled at navigating the patients' health plan
benefits to identify providers, resources and vendors that provide
required care and services. The NCM works collaboratively with the
IDT to provide appropriate, effective, high quality, and
cost-effective care to engaged patients in their current residence.
-If a patient requires care outside their residence, the NCM
collaborates with community-based service providers to ensure
coordinated care during critical times of transition between health
care settings and home. - In addition to the NCM, the Landmark IDT
consists of the Regional Medical Director, Pod Leaders, mid-level
practitioners, Health Services Director (HSD), clinical
supervisors, behavioral health clinicians, social workers,
pharmacists, dietitian/nutritionist, ambassadors, care
coordinators, the patient and/or caregiver and family. - Primary
Responsibilities:
- Acts as an advocate for the patient -
- Engages and collaborates with patient/caregiver and providers
to develop an individualized Care Plan that addresses disease
management, health promotion, and patient-centered goals
- Monitors patient progress against Care Plan goals with an
emphasis on patient care needs during times of transition in care
setting and changes in health status
- In a Delegated Case Management market, understands and adheres
to regulatory timeframes and standards required by National
Committee for Quality Assurance (NCQA) -
- Provides disease management, health promotion and prevention
education to patients/caregivers and/or family members to manage
disease progression and encourage proper medical testing, so
patient can remain as independent as possible -
- Completes initial and ongoing patient assessment, using
information gathered from patient/caregiver/family, providers,
Landmark EMR, and available medical records
- Ability to manage and coordinate care and services within an
Interdisciplinary Team
- Manage incoming clinical calls to ensure patients' medical
concerns are addressed by the care team in a timely manner
- Comfortable having and documenting advance directive
conversations with patient/caregiver and/or family, and collaborate
to reconcile patient/caregiver goals with the current clinical
status -
- Coordinates care needs across the continuum of care and is the
point of contact for patient/caregiver and clinicians -
- Leads daily IDT Huddle
- Actively participates in Landmark meetings and education
sessions
- Acts as liaison between providers, nursing facilities,
hospitals and program staff, including making recommendations about
care alternatives
- Facilitates/coordinates admission to a recommended level of
care on a temporary or permanent basis
- Promotes patient safety. Reviews or initiates a home safety,
functional assessment, and/or falls risk assessment with home-based
providers to determine need for adaptive equipment. Assists with
acquisition of assistive equipment, as recommended -
- Monitors patient during admissions and provides
nursing/assisted living facility and provider training on Landmark
program philosophy and approach to patient care -
- Identifies and reports any potential quality-of-care issues to
Clinical Supervisor/HSD, so a plan of improvement can be developed
and implemented, as needed
- At times, the NCM may visit a patient in their home for
education or assessment, Market/State dependent
- Maintains HIPAA compliance at all times - Supervisory:
- Reports directly to the Supervisor, Clinical Nurse Competency:
To perform the job successfully, an individual should demonstrate
the following competencies:
- Problem Solving -- Identifies and resolves problems in a timely
manner; gathers and analyzes information skillfully; develops
alternative solutions; works well in group problem solving
situations; uses reason even when dealing with emotional
topics
- Customer Service -- Manages difficult or emotional customer
situations; responds promptly to customer needs; solicits customer
feedback to improve service; responds to requests for service and
assistance; meets commitments
- Interpersonal Skills -- Focuses on solving conflict; maintains
confidentiality; listens to others; keeps emotions under control
and overcomes resistance when necessary; remains open to new
ideas
- Oral Communication -- Speaks clearly and persuasively in
positive or negative situations; listens and seeks clarification;
responds openly to questions. -Must be able to deal with frequent
change, delays, or unexpected events
- Attendance/Punctuality -- Is consistently at work and on time;
ensures work responsibilities are covered when absent; arrives at
meetings and appointments on time
- Dependability -- Follows instructions, responds to management
direction; takes responsibility for own actions; keeps commitments;
commits to long hours of work when necessary to reach goals;
completes tasks on time or notifies appropriate person with an
alternate plan
- Initiative -- Volunteers readily; undertakes self-development
activities; seeks increased responsibilities; takes independent
actions and calculated risks; looks for and takes advantage of
opportunities; asks for and offers help when needed; generates
suggestions for improving work and workflow You'll be rewarded and
recognized for your performance in an environment that will
challenge you and give you clear direction on what it takes to
succeed in your role as well as provide development for other roles
you may be interested in. Required Qualifications: To perform this
job successfully, an individual must be able to perform each
essential duty satisfactorily. -The requirements listed below are
representative of the knowledge, skill, and/or ability required.
-Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential functions.
- Hold RN License in the State(s) where you will practice. RN
License must be current, active, unrestricted and unencumbered
-
- 3+ years of clinical practice in a hospital, home care,
hospice, clinic, or nursing home setting
- Electronic Medical Record documentation experience -
- Proficient in patient-centered Care Plan creation and active
management -
- Computer skills: internet navigation, Microsoft Office -
Outlook, Word and Excel
- Access to reliable transportation; if you are driving a
vehicle, you must comply with all the terms of the Landmark Motor
Vehicle Safety policy Preferred Qualifications:
- BSN -
- 1+ years of Utilization Management experience
- Case Management experience
- Disease state management experience with solid ability to
educate patients on health and wellness
- Population Health management experience
- Ability to manage a patient caseload using data and
reports
- Advanced interpersonal and telephonic communication skills
- Solid organizational skills
- Ability to complete all work independently and within
designated timeframes
- Adaptable, flexible, and able to maintain a positive attitude
during change in process, practice or policy
- Full COVID-19 vaccination is an essential job function of this
role. Candidates located in states that mandate COVID-19 booster
doses must also comply with those state requirements. UnitedHealth
Group will adhere to all federal, state and local regulations as
well as all client requirements and will obtain necessary proof of
vaccination, and boosters when applicable, prior to employment to
ensure compliance. Candidates must be able to perform all essential
job functions with or without reasonable accommodation. Physical
Demands: Below are the physical requirements which are
representative of those that must be met by the employee to
successfully perform the essential functions of the job.
-Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential functions. -
- Regular requirement to sit; use hands to touch, handle or
feel.
- Regular requirement to talk and listen.
- Occasional requirement to stand; walk and reach with hands and
arms
- Occasional requirement to lift and/or move up to 10 pounds.
-
- Vision abilities include close vision, peripheral vision, depth
perception and ability to adjust focus. -
- Ability to travel frequently car Work Environment: Below is a
description of the work environment that the employee will
encounter while performing the essential functions of the job. -
- Initial high frequency visits to patient residences followed by
as needed visits during market implementations
- Will require regular travel to patient residences and
non-home-based market offices
- Noise level is usually moderate To protect the health and
safety of our workforce, patients and communities we serve,
UnitedHealth Group and its affiliate companies require all
employees to disclose COVID-19 vaccination status prior to
beginning employment. In addition, some roles and locations require
full COVID-19 vaccination, including boosters, as an essential job
function. UnitedHealth Group adheres to all federal, state and
local COVID-19 vaccination regulations as well as all client
COVID-19 vaccination requirements and will obtain the necessary
information from candidates prior to employment to ensure
compliance. Candidates must be able to perform all essential job
functions with or without reasonable accommodation. Failure to meet
the vaccination requirement may result in rescission of an
employment offer or termination of employment Careers with Optum.
-Here's the idea. We built an entire organization around one giant
objective; make health care 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.
Keywords: UnitedHealth Group, Orlando , Nurse Care Manager - North Bend, OR, Executive , Orlando, Florida
Didn't find what you're looking for? Search again!
Loading more jobs...