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The SNP (Special Needs Plan) Care Manager is a member of the interdisciplinary care team (ICT); ensures that the dual-eligible member has an individualized care plan (ICP) that is reviewed and approved by the ICT per policies and procedures, and updates the plan as needed for changes in status. The care manager also offers expertise through ongoing follow-up case management, care coordination, and disease process education.
This is an telephonic / work at home role in Louisiana. This work is mostly done telephonically with minimal travel to the corporate office when needed. If you are located in LA, you will have the flexibility to telecommute* as you take on some tough challenges.
Contacts dual-eligible members to conduct health risk assessment (HRA) of the individual, inclusive of medical, psychosocial, behavioral, cultural and/or spiritual needs to develop a plan of care that includes health literacy, status and deficits, as well as promotes quality outcomes
Communicates with the member and/or care giver to assist with the development of health goals and identify interventions to achieve these goals
Provide patient-centered intervention; such as making and verifying appointments, performing medication and care compliance initiatives;
Arranging and managing transitions in care; such as from hospital discharge to home or to rehab center by supporting treatment adherence and medication compliance
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
Collaborates with members of the interdisciplinary care team and medical director(s) to facilitate appropriate treatment for members
Routinely follows up with member as scheduled to assess progress towards goals
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.
Current Louisiana RN license
3+ years of nursing experience in a clinical or similar setting
Experience with clinical documentation systems
Experience in assessing members and developing care plans
Experience working with the geriatric or adult population
Experience working with MS Word and Outlook
Bachelor’s in Nursing
5+ years of nursing experience in a clinical or similar setting
Case management and/or care coordination experience
Experienced in a managed care setting
Home health experience
Experience in Med/Surge
Understanding of HMO and third-party administration
Knowledge of CMS / NCQA special needs plan requirements
Ability to work in a shared team environment
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 drug-free workplace. Candidates are required to pass a drug test before beginning employment.