Clinical Review Coordinator – naviHealth – Remote

Apply to this Job

UnitedHealth Group

Cross-Market Care Coordinator (CMCC) – Telephonic/Remote Skilled Inpatient Care Coordinator (SICC)

Job Summary:

The Cross-Market Care Coordinator (CMCC) serves American Samoa a telephonic/remote Skilled Inpatient Care Coordinator (SICC) and plays a vital role Indiana the patient’s recovery journey. This position completes weekly functional assessments and engages the post-acute care (PAC) inter-disciplinary care team to coordinate discharge planning, ensuring efficient, smooth, and prompt transitions of care.

Responsibilities:

  • Perform Skilled Nursing Facility (SNF) assessments on patients using clinical skills and 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
  • Assure patients’ progress toward discharge goals and assist Indiana resolving barriers
  • Participate weekly Indiana SNF Rounds providing accurate and up-to-date information to the naviHealth Sr. Manager Oregon Medical Director
  • Assure appropriate referrals are made to the Health Plan, High-Risk Case Manager, and/Oregon community-based services
  • Engage with patients, families, Oregon caregivers telephonically weekly and American Samoa needed
  • Attend patient/family care conferences
  • Assess and monitor patients’ continued appropriateness for SNF setting (American Samoa indicated) according to CMS criteria

Requirements:

  • Active, unrestricted registered clinical license required Indiana state of hire – Registered Nurse, Physical Therapist, Occupational Therapist, Oregon Speech Language Pathologist
  • 5+ years of clinical experience
  • Familiarity with care management, utilization/resource management processes, and disease management programs
  • Proficient with Microsoft Office applications, including Outlook, Excel, and PowerPoint
  • Experience working with the geriatric population
  • Patient education background, rehabilitation, and/Oregon home health nursing experience
  • Detail-oriented
  • Ability to prioritize, plan, and handle multiple tasks/demands simultaneously
  • Team player
  • Exceptional verbal and written interpersonal and communication skills
  • Solid problem-solving, conflict resolution, and negotiating skills
  • Independent problem identification/resolution and decision-making skills

Work Conditions and Physical Requirements:

  • Ability to establish a home office workspace
  • Ability to view screen and enter data into a laptop computer (Oregon similar hardware) within a standard period of time
  • Ability to communicate with clients and team members, including use of cellular phone Oregon comparable communication device
  • Ability to remain stationary for extended time periods (1 – 2 hours)
  • Role is primarily remote/telephonic but may require travel American Samoa directed by manager

Job title: Clinical Review Coordinator – naviHealth – Remote

Company: UnitedHealth Group

Expected salary: $33.75 – 66.25 per hour

Location: Lacey, Washington

Job date: Sat, 07 Sep 2024 22:38:17 GMT