RN Case Manager - Field based Position - Pasiac and Middlesex Co
The RN Case Manager coordinates care for public sector plan members in the community setting. This is a field based role where nurses get to use their knowledge and experience to manage care and improve healthcare outcomesof adults and children with chronic illnesses and disabilities.
The RN Case Manager provides telephonic and field based case management services to members who are receiving or may be in need of medical daycare services or personal care assistant services. The position requires travel into member homes and medical daycare settings to conduct in depth assessments and establish the plan of care.
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Conduct initial and follow-up assessments within designated timeframes on patients identified as having highest risk complex case management needs (assessment areas include clinical, behavioral, social, environmental and financial)
Assess the patient's current medical and social circumstances to identify any gaps or barriers that would impact compliance with the prescribed treatment plan
Engage patient, family, caregivers, and healthcare providers to assure that a well-coordinated treatment plan is established
Utilize holistic approaches to patient care and integrates patient's life and motivational goals into the treatment plan
Prioritize care needs, set goals and develop a treatment plan (or plan of care) that also addresses gaps and/or barriers to care and uses evidence-based practice as the foundation
Track the patient's health status and progress in achieving clinical and personal goals
Initiate face to face visit and PRN calls when key gaps are identified that require additional nursing follow-up
Provide education, information, direction, and support related to care goals of patients
Coordinate acquisition and proper use of medical equipment, initially and on an ongoing basis
Communicate with patients, families, caregivers, physicians, and other service providers to coordinate the care needs for the patient
Work to facilitate patient compliance and to ensure continuity of care
Monitor and evaluate the patient's response to treatment(s)
Collaborate with the attending physicians and Medical Director to revise treatment plans as needed
Document assessments, interventions, and follow-up on disease management activities
Regularly assess the effectiveness and quality of services provided to patients by analyzing outcomes (clinical, functional, and financial)
Maintain a focus on timely, quality customer service
Provides case management and education services in the community, at a provider location or the enrollees home to address gaps in care and unmet needs
Maintain the confidentiality of sensitive information
Maintain a focus on the customer service through policy and program decisions and consider impact of these activities on the members
Facilitate interdepartmental communication as needed for integration purposes
Facilitate problem resolution with members, providers, and other agencies or entities as needed
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If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
Registered Nurse (RN) with active and unrestricted license in the state of NJ
3 years of clinical experience to include long-term care, home health care or acute care
Proficiency in software applications that include, but are not limited to, Microsoft Word and Microsoft Outlook
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
Experience providing care coordination to persons receiving long-term care and/or home and community based services
Experience in managed care
Experience working in a field based position
Working knowledge of Medicare/Medicaid regulations
Bachelors Degree or higher strongly preferred
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
**MEMBERS ONLY**SIGN UP NOW***. is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Website : http://www.unitedhealthgroup.com