Submission for the position: Practice Performance Consultant - Field Based - Tampa, FL - (Job Number: 2019734)
Practice Performance Consultant - Field Based - Tampa, FL
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 is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)
This is a field-based position traveling to physician practices. Case managers review charts (paper and electronic - EMR), look for gaps in care, perform assessments, help coordinate doctor appointments, make follow-up calls to members after appointments, and assist our members in overall wellness and prevention. Case managers primarily work at physician practices on a daily basis.
If you are located in Tampa, FL, you will have the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:
• Conduct telephonic member needs assessments according to state and national guidelines, policies, procedures, and protocols
• Interact with patients via telephone; Schedule appointments, Follow up calls to assess understanding of services, answer questions and ascertain that additional procedures have been completed
• Provides care coordination/case management through physician practices for members to improve clinical quality and clinical documentation. No direct patient care
• Review member charts prior to a physician appointment and create alerts/triggers to highlight Star opportunities for the practice
• Partner with the practice's administrative and clinical staff while managing patient appointments and data between visits
• Create and maintain a professional and supportive relationship with the patient, provider and office staff
• Facilitates appropriate member referrals to special programs such as Behavioral Health, Advanced Illness and Social Services
• Assists the member to access community, Medicare, family and other third-party resources as appropriate
• Collaborates and communicates with the member’s health care and service with our interdisciplinary delivery team to coordinate the care needs for the member
• Provides education to members regarding health care needs and available services
• Works to facilitate member compliance with their care/treatment plan and to ensure continuity of care
• Identifies barriers to optimal care and outcomes or clinical concerns and communicate with members and providers to formulate action plan to address
• Documents all care coordination activities and interventions in the member’s health plan clinical record
• Maintains a focus on timely, high-quality customer service
• Maintains the confidentiality of all sensitive information
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.
Required Qualifications:
• Current, unrestricted RN license in the State
• 3 years of clinical experience in a hospital, acute care, home health, direct care or case management
• Computer/typing proficiency to enter/retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications including MS Office and Excel
• Able to travel to provider offices within service area - may require up to 1 hour radius for travel
• Reliable transportation, valid and unrestricted driver’s license, proof of insurance and ability to travel to provider offices or other locations within service delivery area
• Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance
Preferred Qualifications:
• Bachelors of Science in Nursing
• Case Management experience including Certification in Case Management
• Experience with HEDIS and EMR (electronic medical records)
• Experience with navigating and analyzing reports in Microsoft Excel
• Medicaid, Medicare, Managed Care experience
• Physician Office experience
• Experience in intensive care (ICU),emergency department (ER) nursing, or Home Health
• Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
• Call Center experience
• Home care/field based case management
• Bilingual - Spanish
• 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
• Demonstrated ability to identify with a consumer in order to understand and align with their needs and realities
• Demonstrated ability to perform effective active listening skills to empathize with the customer in order to develop a trust and respect
• Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done in order to achieve a goal(s)
• Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer
If the hired individual resides in Florida (office based or telecommuting) this position requires the ACHA Level 1 background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years.
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)
*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.
Job Keywords: Practice Performance Consultant, Field Based, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Sarasota, FL, Florida
Case Management
US-FL-Tampa
UHC & Optum Partners
Oct 21, 2021, 10:39:07 AM
Schedule: Full-time Location(s): US-FL-Tampa