Job Description

The Nurse Case Manager will act as an advocate for patients and their families guide them through the health care system for transition planning and longitudinal care. The Nurse Case Manager will work in partnership with an assigned Care Advocate and Social Worker.

If you are located in the Dallas / Fort Worth, TX area, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

* Engage patient, family, and caregivers telephonically to assure that a well-coordinated action plan is established and continually assess health status
* Provide member education to assist with self-management goals; disease management or acute condition and provide indicated contingency plan
* Identify patient needs, close health care gaps, develop action plan and prioritize goals
* With oversight of RN and/or MD, utilizing evidence-based practice, develop interventions while considering member barriers independently
* Provide patients with welcome home calls to ensure that discharged patients' receive the necessary services and resources according to transition plan
* In partnership with care team triad, make referrals to community sources and programs identified for patients
* Collaborates effectively with Interdisciplinary Care Team (IDCT) to establish an individualized transition plan and/or action plan for patients
* Demonstrate knowledge of utilization management processes and current standards of care as a foundation for utilization review and transition planning activities
* Performs all other related duties as assigned

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:

* Licensed Practical/Vocational Nurse
* Current, unrestricted LPN/LVN license required, specific to the state of employment
* 2+ years of managed care and/or case management experience
* 2+ years of clinical experience
* If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

* Case Management certification
* Skills in planning, organizing, conflict resolution, negotiation and interpersonal skills to work with autonomy in meeting case management goals and initiatives
* Knowledge of utilization management and/or insurance review processes as well as current standards of care, a strong knowledge of health care delivery systems and the ability to interact with medical directors, physician advisors, clinicians and support staff
* The ability to work independently in accomplishing assignments, program goals and objectives
* Proficient computer skills in Microsoft applications and Microsoft Excel

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 380,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

Colorado Residents Only: The salary/hourly range for Colorado residents is $17.12 to $30.34. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*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: LPN, LVN, case manager, Dallas, Fort Worth, TX, Texas