Position Description: Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work. The primary purpose of the LVN Telephonic Service Coordinator is to deliver Telephonic Support Service Coordination, Community Resource integration, and Psychosocial support. This results in consistent, collaborative, and coordinated care based on member needs and risk profile. Identifying members needs begins with early identification of Health Risk factors, as identified by the member. Employees in this position require various Nurse Licensure and Certification, based on role and grade level. Licensure includes LPN / LVN, depending on grade level, with current, unrestricted licensure in The State of Texas. These roles identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. This function is responsible for Clinical Operations and Medical Management activities across the continuum of Care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes Case Management, Coordination of Care, and Medical Management Consulting. This role may also be responsible for providing Health education, Coaching and Treatment Decision support for Members. Includes Health Coach, Health Educator, and Health Advocate roles that require an RN. Primary Responsibilities:Basic, structured, and standard approach to work.Engage Member and Stratify:Respond with appropriate coordination of Care and Services protocol by level of Care assignment.Complete telephonic Risk Stratification Assessment, if necessary.Contact member to explain Care Management process and complete Welcome Call Assessments on New members.Share input into the Plan of Care with appropriate members of the Care team so that Care Team members are working toward uniform Member goals.Utilize Motivational Interviewing techniques to obtain Member information, including: family, caregivers, Providers' reporting, etc.Deliver and coordinate services.Identify formal and informal resources to meet the member needs as stated in the Plan of Care.Enter Service notifications / authorizations according to guidelines.Communicate with the Member, Primary Care Physician, and Community partners concerning Service and Behavioral Health needs, as well as alternatives to providing services to meet those needs.Serve as Member advocate and facilitator to resolve issues that may be barriers to care.Through developing a relationship with the member / family, the Care Manager educates the member / family about their Behavioral Health conditions, Socialization options, Treatment options, Community resources, and Insurance benefits so that informed decisions can be made and Member self-management is promoted.Complete delegated activities from the Health Services Manager, as appropriate, surrounding the provision of information related to Health conditions and Treatment options as a part of the Plan of Care.Ensure appropriate utilization and consistent application of Benefits, and apply Benefits Coordination knowledge.Maintain time-sensitive documentation, including Case Management / Service Coordination interventions and outcomes to assure compliance with regulatory agencies and program goals.Perform other duties, as assigned. Candidate must live within 50-miles of Sugarland, TX. The Training Location is at Sugar Creek on the Lake, 14141 Southwest Freeway, Sugar Land, TX 77478.
Required Qualifications:High School Diploma / GEDLicensed Vocational Nurse (LVN) Licensure within the State of Texas3+ years of clinical experience as a LVN1+ years working knowledge of Medicare / Medicaid Regulations1+ years working knowledge of Medical TerminologyMust be able to create, copy, edit, save and send documents utilizing Microsoft Word, Microsoft Excel and Microsoft OutlookAccess to reliable transportation that will enable you to travel to client and / or patient sites within a designated areaMust travel to the Sugar Land, TX office up to 8 weeks for trainingPreferred Qualifications:Bilingual fluency with English and SpanishLong Term Care experienceManaged Care experience in a Care Coordination roleExperience in a Health-related, Telephonic Customer Service settingExperienced in meeting the needs of vulnerable populations who have chronic or complex conditionsCase Management experience in a clinical setting (i.e., Hospital, Long Term Care, etc.)Careers 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 healthcare here. We serve the healthcare 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 Healthcare, Community, and Government partners to heal healthcare and create positive change for those who need it most. This is the place to do your life's best work. 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. Keywords: UnitedHealth Group, Optum, Healthcare, Long Term Care, Long Term Care, Telephonic Customer Service, Case Management, Licensed Vocational Nurse, Medicare/Medicaid, Medical Terminology, Word, Excel, Outlook, Sugar Land, TX
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.