Field RN Service Coordinator - Case Manager - Remote in El Paso Texas

Improve the lives of others while Caring. Connecting. Growing together.

Job Description
- Field RN Service Coordinator 1 - Case Manager
- Remote in El Paso Texas (2387753)

Field RN Service Coordinator 1 - Case Manager
- Remote in El Paso Texas - 2387753

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that’s driving the health care industry forward. As a Telephone Case Manager RN with United Health Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come.

Ready for a new path? Apply today!

If you are located in El Paso, TX you will have the flexibility to work remotely
* as you take on some tough challenges.

• Conducting telephonic or face to face holistic evaluations of Member's individual dynamic needs and preferences gathering relevant data and obtaining further information from Member/family identification, evaluation, coordination, and management of member's needs, including physical health, behavioral health, social services, and long-term services and supports
• Provides education and support to Member/LAR on options of Consumer Directed, or Service-Related delivery models as applicable
• Performs initial assessments and follow-up assessments and outreach calls within the time specified as part of contractual guidelines or per Member/family/provider request
• Identifies members for high-risk complications and coordinates care with the member and the health care team
• Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefit
• Assess, plan, and implement care strategies that are individualized for each member and directed toward the most appropriate, least restrictive level of care
• Utilize both company and community-based resources to establish a safe and effective case management plan for members
• Collaborate with member, family, and healthcare providers to develop an individualized plan of care
• Identify and initiate referrals for social service programs, including financial, psychosocial, community, and state supportive services
• Manage care plan throughout the continuum of care as a single point of contact
• Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
• Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the healthcare team
• Utilize approved clinical criteria to assess and determine appropriate level of care for members
• Document all member assessments, care plan and referrals provided
• Participate in Interdisciplinary team meetings and Utilization Management rounds and provide information to assist with safe transitions of care
• Understand insurance products, benefits, coverage limitations, insurance, and governmental regulations as it applies to the health plan
• Monitor services being delivered to ensure timeliness, appropriateness, and satisfaction in meeting Member needs
• Reports medically complex cases to appropriate roles as necessary for review and problem solving
• Maintains status on face to face and telephonic visit requirements for assigned Members

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.

• Graduate of an accredited school of nursing
• 3+ years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities as a Service Coordinator, Case…