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The Care Coordinator, as a part of the primary care patient centered medical home team, engages in a collaborative process, which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet a member’s health needs through communication and available resources to promote quality, cost effective outcomes. The Care Coordinator is responsible for ensuring a member’s encounter with providers, office staff, and Peoples Health is seamless and comprehensive. The Care Coordinator will review, plan, and coordinate health care services in order to utilize appropriate processes and appropriate resources to improve member’s health outcomes.
If you are located in or near Metairie, LA, you will have the flexibility to telecommute* as you take on some tough challenges.
Provides patient-centered interventions; such as performing medication and care compliance initiatives, case management, etc.
Assesses the total individual, inclusive of medical, psychosocial, behavioral, cultural and/or spiritual needs to develop a plan of care that promotes quality outcomes
Interacts with the member and the multidisciplinary team to establish measurable health care goals and prioritization of the member’s needs. Monitors the member’s adherence to the plan of care
Serves as health coach to educate the member, the family and/or caregiver, about disease status and treatment, plan benefits, community resources, and resource options
Assists member with scheduling appointments with the primary care provider (PCP), specialists’, referrals, follow-up testing and/or office procedures
Creates a “fact pack” for the provider by identifying HEDIS/Star measures needed, reviews current and past medication record, and current services being provided
Monitors performance against assigned member’s gaps in HEDIS and Star measures through weekly report analysis and ensures receipt, review and documentation of test and treatment results
Identifies, plans and documents all follow up to hospital treatment with the interdisciplinary team and primary care physician (PCP). Within seven (7) days following post-hospital discharge, coordinates with other team members, to perform medication reconciliation and alert provider to any issues and/or discrepancies
Collaborates in efforts that focus upon moving the individual to self-care when possible
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.
Licensed RN, eligible to practice in the State of Louisiana
2+ years of experience in a clinical setting
Experience with clinical documentation systems
Experience in assessing members and developing care plans
Intermediate Microsoft Office experience working with Microsoft Word, Excel, and Outlook (ability to create, edit, save and send documents, spreadsheets and emails)
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Bachelor’s degree in Nursing
Disease management or chronic care improvement experience
Case Management or Care Coordination experience
Experience in a managed care industry setting
Quality improvement experience in a managed care setting
Understanding of HMO and third-party administration
Understanding of nursing home and long-term acute care regulations
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.
UnitedHealth Group is a drugfree workplace. Candidates are required to pass a drug test before beginning employment