Care Coordinator, Onsite - Farmington, MO Hybrid - RN​/PT​/OT​/ST

Position: Care Coordinator, Onsite - Farmington, MO - (Hybrid - RN/PT/OT/ST)
Optum Home & Community Care Delivery, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum Care at Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services.

This preventive care can help patients stay well 're connecting care to create a seamless health journey for patients across care settings. Join us to start  
** Caring. Connecting. Growing together.*
* The Care Coordinator, Onsite plays an integral role in optimizing patients' recovery journeys. The Care Coordinator completes weekly functional assessments and engages the post-acute care (PAC) inter-disciplinary care team to coordinate discharge planning to support the members PAC journey. The position engages patients and families to share information and facilitate informed decisions. By serving as the link between patients and the appropriate health care personnel, the Care Coordinator is responsible for ensuring efficient, smooth, and prompt transitions of care.

*
* Primary Responsibilities:

*
* + By serving as the link between patients and the appropriate health care personnel, the Care Coordinator is responsible for ensuring efficient, smooth, and prompt transitions of care

+ Engage with patients, families, or caregivers either telephonically or on-site weekly and as needed. Collaborate effectively on discharge goals and assist in resolving barriers

+ Collaborate effectively with members health care teams with individualized communication and participation in interdisciplinary team meetings

+ Review target outcomes and discharge plans with providers and families

+ Perform Skilled Nursing Facility (SNF) assessments on patients using clinical skills and utilizing CMS criteria upon admission to SNF and periodically through the patient stays

+ Assess and monitor patients' continued appropriateness for SNF setting (as indicated) according to CMS criteria

+ Complete all SNF continued stay reviews, updating authorizations on a timely basis

+ When Care Transitions is delegated for utilization management, review referral requests that cannot be approved for continued stay and are forwarded to licensed physicians for review and issuance of the NOMNC when appropriate

+ Complete cross-training and maintain knowledge of multiple contracts/clients to support coverage needs across the business

+ Manage assigned caseload efficiently and effectively utilizing time management skills

+ Enter timely and accurate documentation into Coordinate

+ Adhere to organizational and departmental policies and procedures

+ Maintain confidentiality of all PHI information in compliance with HIPPA, federal and state regulations, and laws

+ Hold patients' protected health information confidential as required by applicable laws, regulations, or agency/institution procedures

+ Keep current on federal and state regulatory policies related to utilization management and care coordination (CMS guidelines, Health Plan policies, and benefits)

+ Adhere to all local, state, and federal regulatory policies and procedures

+ Attend H&C Transitions meetings as requested

+ Promote a positive attitude and work environment

+ Perform other duties and responsibilities as required, assigned, or requested

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:

*
* + Active, unrestricted registered clinical license required in state of hire - Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Language Pathologist

+ Candidate hired will support specific location(s) for on-site facility needs within 30-mile maximum radius of home location based on manager discretion

+ You must reside within or near the county listed on the job description

+ 5+ years of clinical experience

*
* Preferred Qualifications:

*
* + Experience working with the geriatric population

+ Patient education background, rehabilitation, and/or home health nursing experience

+ Familiarity with care management, utilization/resource management processes and disease management programs

+ Proficient with Microsoft Office applications including Outlook, Excel and Power Point

+ Proven detail-oriented

+ Proven ability to prioritize, plan, and handle multiple tasks/demands simultaneously

+ Proven team player

+ Proven exceptional verbal and written interpersonal and communication skills

+ Proven solid problem solving, conflict resolution, and negotiating skills

+ Proven independent problem identification/resolution and decision-making skills

** Work Conditions and

Physical Requirements *
* +…