Case Manager Licensed Practical Nurse - Tampa, FL - Full-time / Part-time

Position Description:

Energize your career with one of Healthcare's fastest growing
companies.  

You dream of a great career with a great company – where you can
make an impact and help people.  We dream of giving you the opportunity to
do just this.  And with the incredible growth of our business, it's a
dream that definitely can come true. Already one of the world's leading
Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to
operate our Service Centers, improve our Service levels and help people lead
healthier lives. We live for the opportunity to make a difference and right
now, we are living it up.

This opportunity is with one of our most exciting business areas:
Optum –a growing part of our family of companies that make UnitedHealth Group a
Fortune 14 leader.

Optum helps nearly 60 million Americans live their lives to the
fullest by educating them about their symptoms, conditions, and treatments;
helping them to navigate the system, finance their Healthcare needs, and stay
on track with their Health goals. No other business touches so many lives in
such a positive way. And we do it all with every action focused on our shared
values of Integrity, Compassion, Relationships, Innovation, and Performance.

This is a Telecommute position in which you will be assigned to Long Term Care facilities in the Tampa, FL area. You will plan decide which facilities you will visit and which members you will see, daily. You will be responsible for documenting your visits and assessments in the EMR. You will identify and coordinate the appropriate levels of care under the direct supervision of an RN or MD. You must be able to work autonomously and stay self-motivated, with little supervision. 

Requires current & unrestricted LPN licensure in the State of Florida.

Primary
Responsibilities:

• Document Milliman Guideline(s) on every inpatient case
within 24 hours of receipt and update guideline as hospitalization continues.

• Review inpatient cases with UM Manager on a daily basis
and communicate discharges by 12 noon.

•  Notify patients'
Primary Care Physician of admission, discharge and discharge plan within 24
hours of each event as appropriate.  

• Utilize the nursing process to establish individual
patient goals and measures patients' response to the plan of care for
appropriate outcomes and intervene appropriately

•   Explore care
options to reduce cost, decrease length of stay, curtail re-admission and
influence quality outcomes.

•  Maintain knowledge
regarding network providers and current contracted specialists

•  Understand health
plan benefits and contractual information.

•  Generate
authorizations utilizing principles of UM

•  Accurately use
database for daily documentation of clinical information, opportunity days,
denied days and levels of care.

•  Follow policy and
procedure for Denials and enters this information into the database with 24
hours of the event.

•  Meet all health
plan contract compliance directives for utilization.

•  Maintain ongoing
communication and feedback with customers and/or clients in order to support
needs and resolve problems.

•  Attend
weekly/monthly group committees as requested.

•  Manage error reports
on a weekly basis.

•  Communicate
activities and progress of assigned committees and teams to appropriate staff.

•  Identify and refer
members to Case Management prior to discharge or as deemed appropriate through
referral review.

• Assure discharge plans are implemented.

• Confer with Hospitalist on call as appropriate.

• High School Diploma/GED.
• Current & unrestricted LPN licensure in the State of Florida.
• 4+ years of LPN experience.
• 1+ year of Managed Care experience.
• Computer proficiency, including the ability to navigate through a Windows environment and to utilize Microsoft Word and Excel to perform data entry, sorting, & filtering.
• Ability to Type 30 - 40 WPM.
• Must have a reliable form of transportation and a current Driver's License as this position does have 75% travel within the local area.

At
Optum, you will perform within an
innovative culture that's focused on transformational change in the Healthcare
system. You will leverage your skills across a diverse and multifaceted
business. And you will make contributions that will have an impact that's
greater than you've ever imagined.

Diversity
creates a healthier atmosphere: All qualified applicants will receive
consideration for employment without regard to race, color, religion, sex,
national origin, protected veteran status, or disability status. 

UnitedHealth
Group
is a drug-free workplace. Candidates are required to pass a drug test before
beginning employment. In addition, employees in certain positions are subject
to random drug testing.

Keywords:  Licensed
Vocational Nurse, LVN,  Licensed
Practical Nurse, LPN, case management, utilization management, city, state