Remote Skilled Inpatient Care Coordinator Hybrid

Optum

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Requisition Number: 2223931
Job Category: Medical & Clinical Operations
Primary Location: Passaic, NJ
(Remote considered)

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs – helping patients access and navigate care anytime and anywhere.

As a team member of our naviHealth product, we help change the way health care is delivered from hospital to home supporting patients transitioning across care settings. This life-changing work helps give older adults more days at home.

We’re connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together. 

Why Home and Community Care Transitions? 

At Home and Community Care Transitions our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. Home and Community Care Transitions is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company’s technical vision and strategy.

Why naviHealth? 

At naviHealth, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. naviHealth is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company’s technical vision and strategy.

If you are located in Passaic County, NJ, you will have the flexibility to work remotely* as well as work in the office as you take on some tough challenges.

Primary Responsibilities:

  • By serving as the link between patients and the appropriate health care personnel, the SICC is responsible for ensuring efficient, smooth, and prompt transitions of care
  • Perform Skilled Nursing Facility (SNF) assessments on patients using clinical skills and utilizing CMS criteria upon admission to SNF and periodically through the patient stays
  • Review targets for Length of Stay (LOS), target outcomes, and discharge plans with providers and families
  • Complete all SNF concurrent reviews, updating authorizations on a timely basis
  • Collaborate effectively with the patients’ health care teams to establish an optimal discharge. The health care team includes physicians, referral coordinators, discharge planners, social workers, physical therapists, etc.
  • Assure patients’ progress toward discharge goals and assist in resolving barriers
  • Participate weekly in SNF Rounds providing accurate and up to date information to the Home and Community Care Transitions Sr. Manager or Medical Director
  • Assure appropriate referrals are made to the Health Plan, High-Risk Case Manager, and/or community-based services
  • Engage with patients, families, or caregivers either telephonically or on-site weekly and as needed
  • Attend patient/family care conferences
  • Assess and monitor patients’ continued appropriateness for SNF setting (as indicated) according to CMS criteria
  • When Home and Community Care Transitions is delegated for utilization management, review referral requests that cannot be approved for continued stay and are forward to licensed physicians for review and issuance of the NOMNC when appropriate
  • Coordinate peer to peer reviews with Home and Community Care Transitions Medical Directors
  • Support new delegated contract start-up to ensure experienced staff work with new contracts
  • Manage assigned caseload in an efficiently and effectively utilizing time management skills
  • Enter timely and accurate documentation into coordinate
  • Daily review of census and identification of barriers to managing independent workload and ability to assist others
  • Review monthly dashboards, readmission reports, quarterly, and other reports with the assigned Clinical Team Manager, as needed, to assist with the identification of opportunities for improvement
  • Adhere to organizational and departmental policies and procedures
  • Maintain confidentiality of all PHI information in compliance with HIPPA, federal and state regulations, and laws
  • Complete cross-training and maintain knowledge of multiple contracts/clients to support coverage needs across the business
  • Keep current on federal and state regulatory policies related to utilization management and care coordination (CMS guidelines, Health Plan policies, and benefits)
  • Adhere to all local, state, and federal regulatory policies and procedures
  • Promote a positive attitude and work environment
  • Attend Home and Community Care Transitions meetings as requested
  • Hold patients’ protected health information confidential as required by applicable laws, regulations, or agency/institution procedures
  • Perform other duties and responsibilities as required, assigned, or requested

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:

  • Active, unrestricted registered clinical license required in state of hire – Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Language Pathologist
  • 5+ years of clinical experience
  • Proven ability to support specific location(s) for on-site facility needs within 20-mile maximum radius of home location based on manager discretion
  • Reside within or near Passaic County, New Jersey area

Preferred Qualifications:

  • 2+ years of case management experience
  • Patient education background, rehabilitation, and/or home health nursing experience
  • Experience working with geriatric population
  • Experience in a Skilled Nursing Facility
  • Demonstrated detail-oriented
  • Demonstrated team player
  • Proven solid problem solving, conflict resolution, and negotiating skills
  • Demonstrated exceptional verbal and written interpersonal and communication skills
  • Proven independent problem identification/resolution and decision-making skills
  • Demonstrated ability to prioritize, plan, and handle multiple tasks/demands simultaneously

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 5, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we’re doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we’re building a high-performance health care system that works better for more people in more ways than ever. Now we’re looking to reinforce our team with people who are decisive, brilliant – and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

New Jersey Residents Only: The hourly range for this role is $33.75 to $66.25 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves 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.