Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. This is the place to do your life's best work.(sm) In this rewarding and challenging role as one of our newest Field Service Coordinators, you will be responsible for clinical operations and medical management activities across the continuum of care - from assessing and planning to implementing, coordinating, monitoring and evaluating. This includes coordination of services, disease management, and medical management consulting. You will also be responsible for providing health education, coaching and treatment decision support for members. Field Service Coordinators work in the community providing proactive home visits and service coordination to individuals and support to their families. If you are located in Hilo, Hawaii, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Making visits to conduct face to face assessments of member needs Making outbound calls to follow up on members' current health status and needs Identifying gaps or barriers in care plans or service plans Providing patient education to assist with self management Communicate daily with members to meet state regulated guidelines Documenting and tracking activities in multiple computer programs at one time Interacting with Medical Directors on challenging cases Coordinating services for members Making referrals to outside resources Coordinating services as needed (home health, DME, etc.) Educating members on disease processes Encouraging members to make healthy lifestyle changes Utilizing criteria to determine if patients are in the least restrictive environment in which they can receive services Conducting post hospital assessments and adjustments to the service plan and plan of care to ensure that the discharged member receives the necessary services and resourcesWe are currently seeking Field Service Coordinators in Hilo, Hawaii.
Required Qualifications: Current, unrestricted RN or Social Worker license in the State of Hawaii 1+ year of clinical or service coordination experience applicable to the managed care population Strong computer proficiency including the ability to type and talk at the same time and to navigate around a Windows environment Strong communication skills, written and verbal Strong organizational skills and multitasking abilities Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area Preferred Qualifications: 2+ years experience in a hospital setting, acute care, home hospice, direct care experience OR experience as a telephonic Case Manager for an insurance company BSN A background in managed care Case Management experience Certified Case Manager (CCM) Experience / exposure with discharge planning Experience in utilization review, concurrent review and / or risk management Experience with home health, hospice or long term care Experience as a Public Health NurseCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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: RN, Registered Nurse, Case Manager, Social Worker, LCSW, LBSW, LSW, CCM, Quest, Medicaid, Hilo, HI, Hawaii
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.