5 days old

Care Coordinator, RN - Telecommute in NY - 936796

New York, NY 10007 Work Remotely
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  • Job Code
    936796

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

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Spectrum POD, Care Coordinator is responsible for ongoing Clinical care coordination and care Management for members attributed to Physician/Physician Practices participating in UnitedHealthcares UHC Spectrum Program. The Care Coordinator drives Referral Management and appropriate site of service, facilitates Care Transitions and Care for High Risk members; Collaborates with PCP, Specialists, and POD Clinical Pharmacist to insure appropriate, coordinated service delivery. This position integrates pharmacy management, care coordination, utilization management, and care transition management.

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If you are located within commutable distance from Long Island, New York, NY, you will have the flexibility to telecommute* as you take on some tough challenges.

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Primary Responsibilities:

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  • Accountable for successful deployment of UHC's Clinical Support Care Coordination program, UHC Spectrum, at the practice level, including but not limited to integration of care coordination for pharmacy management, care transitions management, and referral management
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  • Build and effectively maintain relationship with the practice leadership and key clinical influencers actively involved in practice day to day operations
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  • Consult with patients identified by PCP as needing a Specialist Referral to recommend High Quality, Lower Cost Premium Designated Specialists; facilitates appointments with Specialists
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  • Track completion of Referral and Member adherence with PCP Care Plan
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  • Consults with patients who have had an Inpatient/ER Discharge; facilitates scheduling transitions of care follow up appointments with PCP / Specialists
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  • Track completion of follow up appointments and Member adherence with PCP Care Plan
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  • Consult with patients identified through PCP referral, Care Continuum / Discharge Notification, Pharmacist referral to discuss diagnosis, Rx plan, care path, and potential barriers to adherence
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  • Check-in on the patient regularly and evaluate and document his/her progress as it relates to care coordination and management responsibilities tied to the Spectrum Program
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  • Educate patients about their condition, medication, and care path
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  • Notifies PCP and Pharmacist on the POD Team of relevant clinical information gathered during calls to patient that may affect the patients disease state or medication regimen
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  • Assist and support department leaders in summarizing and disseminating experience - related learning's by way of team updates, written reports / articles, and / or presentations as called for by directors
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  • Educate & Deploy technology tools to support Practice Transformation
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  • Integrate technology tools into practice workflows
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  • Build and effectively maintain relationship with the practice leadership and key clinical influencers actively involved in practice transformation
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  • Regularly facilitate efficient, effective practice improvement meetings with the practice to monitor, present, and discuss progress on the transformation action plan and achievement in milestones
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  • Use data to analyze key cost, utilization and quality data and interpret results to assess the performance of the practice
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  • Use data to analyze trends and work with stakeholders to agree on and implement proactive strategies to address issues, and measure impact using a PDSA rapid cycle improvement approach; including external practice data
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  • Assist practices in creating workflows to optimize care delivery, introduce best practices improvements, and evaluate outcomes using rapid cycle improvements PDSA methods to reach mutual goals
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  • Educate & Deploy technology tools to support Practice Transformation
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  • Assist and support department leaders in summarizing and disseminating experience - related learning's by way of team updates, written reports / articles, and / or presentations as called for by directors
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  • Work in collaboration with UHC Teams: Clinical Transformation, Health Care Economics, Network, and Optum Care management for disease management programs
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Youll 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.

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Required Qualifications:

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  • Active, unrestricted RN License for the State of New York
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  • 4+ years of Care Coordination or Case Management experience
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  • Background in managing populations with complex medical or behavioral needs
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  • Intermediate+ level proficiency with Microsoft Excel
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  • Technical knowledge of Microsoft Excel; ability to quickly learn Clinical Applications
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  • Willingness to travel 25% for same day, face to face meetings
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  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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Preferred Qualifications:

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  • BSN
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  • Experience preparing and presenting information to clinical and executive level leadership
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  • Physician practice experience
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  • Bilingual: English and Spanish
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  • Strong communication skills with patients, providers and other healthcare professionals
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  • Strong Relationship building skills with internal and practice teams to drive goal alignment
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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)

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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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.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: Care Coordinator, RN, Registered Nurse, Case Manager, Care Coordinator, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, New York, Manhattan, Long Island

Posted: 2021-06-07 Expires: 2021-07-07

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Care Coordinator, RN - Telecommute in NY - 936796

UnitedHealth Group
New York, NY 10007

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