LPN or LVN Disease Management Nurse Case Manager - Remote

UnitedHealth Group; Colorado Springs (CO); 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 quality care delivery. This role involves conducting clinical evaluations, collaborating with members and providers, and implementing case management plans tailored to individual healthcare needs. The position offers the flexibility to work remotely from anywhere in the U.S., providing an exciting opportunity to make a meaningful impact in the lives of patients. If you possess a compact LPN or LVN license and are ready to embrace challenges in a supportive environment, this is the perfect chance to grow your career while contributing to the future of health care.

Qualifications

• Must have a compact LPN or LVN license and ability to work Monday - Friday 8a-5p MST.
• Strong communication skills and ability to conduct clinical evaluations.

Responsibilities

• Facilitates team approach for quality care delivery based on medical conditions.
• Conducts clinical evaluations and develops case management plans.

Skills

Motivational Interviewing

Lean Principles

Clinical Evaluation

Communication Skills

Problem Solving

Education

Compact LPN or LVN License

Tools

MS Office Suite

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.

If you have a compact LPN or LVN license and the ability to work Monday - Friday 8a-5p MST, 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.

Skills:

• All staff members are to promote a positive and productive work environment by acting maturely and responsibly, satisfactorily performing his or her job responsibilities and conducting themselves in a professional, courteous and respectful manner toward fellow employees, physicians and patients.
• Must hold relationships to a high standard- respectful approach to all people and interactions, listening to understand, take emotional accountability and exemplify balance of self with all interactions, be receptive to feedback and opportunities keeping an open mind towards growth.
• Integrates Lean principles, practices and tools to improve operational efficiency, reduce costs and increase customer satisfaction.
• Follows written and oral instructions and completes routine tasks independently.
• Completes annual compliance training on HIPAA/Privacy/Confidentiality/Non-Discrimination/Harassment/Integrity Statement and signed Agreements.
• Ensures confidentiality of patient information following HIPAA guidelines and company policies.
• Attends training to meet requirements of the job position and as needed or mandated by company policies and regulations.
• Has regular and predictable attendance.

Professional Competencies:

• Working knowledge of health care delivery systems.
• Working knowledge of PC applications including MS Office Suite.
• Ability to use written and oral communication skills.
• Ability to read and interpret data.
• Skill in writing clear, grammatically correct, easy to use instructional documentation.
• Ability to identify learning needs, set goals and seek educational opportunities.
• Ability to analyze problems and formulate appropriate plans, solutions, and courses of action.
• Knowledge of age specific communication needs with the ability to listen actively and respond to internal and external customers in a timely, competent manner both verbally and nonverbally.
• Ability to work with frequent interruptions.
• Ability to establish and maintain cooperative working relationships with individuals at all levels of the organization and affiliates.
• Ability to maintain confidentiality of patient and all related entity business matters of the organization and its partners.
• Ability to manage detail and work with accuracy.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and