Medical Behavioral Integration RN Case Manager - Albuquerque, NM
Company: UnitedHealth Group
Location: Albuquerque
Posted on: January 26, 2023
Job Description:
Combine two of the fastest-growing fields on the planet with a
culture of performance, collaboration and opportunity and this is
what you get. Leading edge technology in an industry that's
improving the lives of millions. Here, innovation isn't about
another gadget, it's about making health care data available
wherever and whenever people need it, safely and reliably. There's
no room for error. Join us and start doing your life's best
work.(sm)Compassion is the essential trait that drives superior
health care performance. But it's just a start. At OptumCare
innovative thinking is just as important. Our unique team of health
care providers are an emerging and important part of Optum and the
UnitedHealth Group family of businesses. Our approach is designed
to help physicians and other providers deliver the right care at
the right time in the right setting. That takes smart ideas and
incredible teamwork. And that's where you come in. In this role,
you'll support a clinical team that's helping patients in new and
better ways while giving them a generous helping of compassion and
respect.This position integrates a collaborative process which
plans, implements, coordinates, monitors and evaluates options and
services to meet the members behavioral health needs, using
education, communication and all available resources to promote
quality, cost-effective outcomes.This is a full time, Monday-Friday
position. The RN must be able to travel within assigned territory /
location area to conduct critical face to face assessments.
Territory Assignments are based on business needs. Applicants must
be willing to carry a diverse clinical caseload and visit the
patient in their home, hospital, SNF,etc.Primary
Responsibilities:
- Screens and identifies members with high-risk, long term
chronic conditions who will benefit from care management services.
Monitors utilization as needed. Referrals for cases may originate
from various sources
- Performs member evaluations and onsite visits as needed in
multiple settings, including but not limited to: telephonic,
member's homes, PCP/Specialists clinic, hospital, and skilled
nursing facilities and provides feedback on planned interventions
and outcomes of the plan of care
- Performs comprehensive assessments, identifies and assists
members with high-risk symptoms/diagnoses and/or members with
multiple co-morbidities who will benefit from intervention and
engaging in care management services, information is collected from
the patient, caregiver(s), health care providers and other relevant
parties as needed
- Documents findings and develops individualized careplans in a
concise/comprehensive manner compliant with documentation
requirements and Center for Medicare and Medicaid Services (CMS)
regulations
- Utilizes advanced clinical skills to make effective decisions
to meet the members health, behavioral health and psychosocial
needs, providing coaching, patient education, communication, and
all available resources to promote quality and cost-effective
outcomes
- Documents patient/family status, diagnosis, medications,
treatment plan, goals, interventions, evaluation results,
observations and progress in electronic medical record/proprietary
database in a timely and accurate manner
- Advocates for members and families as needed to ensure the
patients needs and choices are fully represented and supported by
the health care team
- Integrates a collaborative approach by attending
interdisciplinary team meetings with nurses, physicians and patient
care coordinators regarding patient care as needed; Collaborates
with providers to determine acuity of behavioral health concerns
and refer members to appropriate community resources
- Utilizes professional knowledge and critical thinking skills to
facilitate MD consultation on complex and/or complicated cases
- Applies Nursing/Counseling/Social Work theory, knowledge,
professional ethics, methods, and interventions to improve member
health and psychosocial functioning within the scope of licensure
and job function
- Manages assigned case load in an efficient and effective
manner
- Performs all other related duties as assignedYoull 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:
- Current, unrestricted RN license in the state of NM
- 2+ years of clinical experience in an acute care, home health,
hospice, geriatric, behavioral health and / or hospital
setting
- Experience using EMR and CM practice guidelines
- Knowledge of discharge planning alternatives options and
interdisciplinary approaches
- Able to handle sensitive issues with members and providers in a
confidential manner according to HIPAA guidelines
- Access to reliable transportation that will enable you to
travel to client and / or patient sites within a designated area
(up to 75% of the time in the field)
- 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 accommodationOptumCare is
committed to creating an environment where physicians focus on what
they do best: care for their patients. To do so, OptumCare provides
administrative and business support services to both owned and
affiliated medical practices which are part of OptumCare. Each
medical practice part and their physician employees have complete
authority with regards to all medical decision-making and patient
care. OptumCares support services do not interfere with or control
the practice of medicine by the medical practices or any of their
physicians.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
employmentCareers with Optum. Here's the idea. We built an entire
organization around one giant objective; make the health system
work better for everyone. So when it comes to how we use the
world's large accumulation of health-related information, or guide
health and lifestyle choices or manage pharmacy benefits for
millions, our first goal is to leap beyond the status quo and
uncover new ways to serve. Optum, part of the UnitedHealth Group
family of businesses, brings together some of the greatest minds
and most advanced ideas on where health care has to go in order to
reach its fullest potential. For you, that means working on high
performance teams against sophisticated challenges that matter.
Optum, incredible ideas in one incredible company and a singular
opportunity to do your life's best work.(sm)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
drug-free workplace. Candidates are required to pass a drug test
before beginning employment.
Keywords: UnitedHealth Group, Albuquerque , Medical Behavioral Integration RN Case Manager - Albuquerque, NM, Executive , Albuquerque, New Mexico
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