Evaluation of member discharge needs including delays in care and readmission prevention plan Collaboration with providers and members to coordinate care post discharge Participate in rounds with the Medical Director to discuss cases as needed Identification of internal or community-based program support or resources Coordination with the facility Discharge Planner to ensure post hospital services are arranged prior to the member being discharged Assist with coordination of difficult cases needi... more details
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
As a Discharge Care Manager (Eastern Region) at UnitedHealth Group, you will be responsible for implementing day-to-day telephonic case management interventions for identified high risk members. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization.
The Discharge Care Manager (DCM) will coordinate and document the discharge plan in collaboration with other key clinical care team members. The DCM will also follow the member while in the acute inpatient setting.
If you are located in Rhode Island, youll enjoy the flexibility to work remotely as you take on some tough challenges.
Primary Responsibilities:
- Evaluation of member discharge needs including delays in care and readmission prevention plan
- Collaboration with providers and members to coordinate care post discharge
- Participate in rounds with the Medical Director to discuss cases as needed
- Identification of internal or community-based program support or resources
- Coordination with the facility Discharge Planner to ensure post hospital services are arranged prior to the member being discharged
- Assist with coordination of difficult cases needing placement in an alternate level of care facility
- Documentation of discharge activities as outlined in standard operating procedures and data entry strategies
- Participate in team meetings, education discussions and related activities
- Works collaboratively with team members in a matrix environment to ensure an end-to-end positive experience for members, providers and care teams
Youll 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:
- Bachelor of Science in Nursing
- Current, unrestricted RN license
- 5+ years of recent experience in the inpatient acute setting
- 2+ years of experience of discharge planning
- Proficient in typing skills and software applications that includes, but is not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint and Microsoft Outlook
- Experience working with multiple health insurance products (Medicaid, Medicare, Commercial) within the insurance industry, including regulatory and compliance requirements
- Have a designated work space and access to install secure high speed internet via cable/DSL in your home
Preferred Qualifications:
- Case Management certification
- InterQual/MCG Guidelines or other nationally recognized practice guidelines
- Demonstrated ability to assist with focusing activities toward a strategic direction as well as develop tactical plans, drive performance, and achieve targets
- Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
- Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
*All employees working remotely will be required to adhere to UnitedHealth Groups Telecommuter Policy
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employers 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.
