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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.
If you are located California and have an active California LVN license , you will have the flexibility to work remotely* as you take on some tough challenges
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.
Primary 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.
Skills:
- 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.
Professional Competencies:
- 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
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:
- Graduation from an accredited Licensed Vocational Nurse program
- Current unrestricted LVN license in California
- 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
Preferred Qualifications:
- Ability to recognize and act appropriately in situations where patient care needs exceed scope of practice
- Skill in working with a team and the ability to collaborate on projects with colleagues
- Skill in working effectively under deadlines and changing priorities
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California Residents Only: The hourly range for this role is $23.22 to $45.43 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.