- High School Diploma or GED
- Motivational Interviewing
- Driver's License
- Customer Service
- Medical Terminology
- Microsoft Office
Full Time LPN Care Manager Opportunity in Care Management, Roma Location
Overview of Position:
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. Adheres to policies, procedures and regulations to ensure compliance and patient safety. Participation in Compliance and other important training is a condition of employment.
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 telephonic, clinic, facility, or home visits as appropriate.
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 ongoing updates of the care plan 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 clinical team.
Attends departmental meetings and provides constructive recommendations for process improvement.
Performs other duties as assigned.
Required: High School diploma, graduation from an accredited practical nursing program.
Desired: Case Management Certification
Required: Two to five (5) year of previous job related experience in a healthcare environment.
Preferred: Health insurance experience
Excellent communication, interpersonal, organization and customer service skills. Knowledge of medical terminology. Self-motivated, strong computer skills. Attention to detail. Ability to multi-task and work under pressure. Skilled with MS Office software applications
Required: Valid, unrestricted, NM LPN License or valid multi-state compact license.
Must be 21 years or older and have a valid NM State Driver’s license
What's the first thing that happens when one of the leading independent medical groups in the country comes together with a global leader in health care? Opportunity. With DaVita Medical Group, HealthCare Partners, The Everett Clinic, Northwest Physicians Network, MountainView Medical Group and Magan Medical Clinic joining OptumCare and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. We're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting opportunity to do your life's best work.(SM)
Careers with OptumCare. Here's the idea. We built an entire organization around one giant objective; make the health system 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. OptumCare, 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. Here you’ll find incredible ideas in one incredible company and a singular opportunity to do your life's best work.(SM)
Diversity creates a healthier atmosphere: OptumCare and its affiliated medical practices are 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 and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.