LPN Case Manager, Disease Management- Remote MST

UnitedHealth Group; Albuquerque (NM); Remote; Confidential; Full time

Job summary

An established industry player in health care is seeking an Associate Care Manager to facilitate a team approach to delivering quality care. This role involves conducting clinical evaluations, developing case management plans, and collaborating with members and providers to meet healthcare needs. The position offers the flexibility to work remotely from anywhere in the U.S., allowing you to tackle meaningful challenges while promoting self-management and effective health care navigation for members. Join a dynamic team that values your contributions and offers opportunities for professional growth and development in a supportive environment.

Qualifications

• Experience in clinical evaluation and case management required.
• Strong communication and motivational interviewing skills are essential.

Responsibilities

• Conduct clinical evaluations and determine eligibility for case management.
• Develop and implement personalized care management plans.

Skills

Clinical Evaluation

Motivational Interviewing

Care Management

Communication Skills

Education

Bachelor's Degree in Nursing or related field

Certification in Case Management

Tools

Electronic Health Records (EHR)

Telehealth Platforms

Job description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

The Associate Care Manager 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.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• 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 individual interview to obtain data for focused assessment and determines individual needs and prioritizes goals.
• Conducts telephonic, clinic, facility, hospital or home visits as indicated for patient evaluation/engagement.
• 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 activities identified on the individual needs and prioritized goals 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 or clinical teams.
• Attends departmental meetings and provides constructive recommendations for process improvement.
• Ability to effectively delegate action items appropriately to clinical and non-clinical staff in accordance with their role and scope of practice.
• Performs other duties as assigned.

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