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TRICARE Autism RN Case Manager - Phoenix, Arizona
| Hours | Full-time, Part-time |
|---|---|
| Location | Phoenix, AZ Phoenix, Arizona |
About this job
Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Our UnitedHealthcare Military & Veterans organization has been selected to provide quality health care services for those who serve our nation. This is an opportunity to share in something special; an opportunity for all of us to serve those families who have made our nation stronger. It's an inspiring role and it can inspire your career. Find out more about these opportunities to do your life's best work. (sm)
United Healthcare Military and Veterans is currently seeking an ECHO Advanced Access to Autism Demonstration Nurse Case Manager providing case management services for qualified TRICARE beneficiaries requiring specialized healthcare services. As an ECHO, Advanced Access to Autism Demonstration Nurse Case Manager, you will be responsible for providing integrated clinical case management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating care for beneficiaries with high risk diagnoses and complex needs that may require coordination of multiple medical and behavioral health care services. This position provides telephonic case management support for this population. Our mission is to help people live their lives to the fullest. Our values are Integrity, Compassion, Relationships, Innovation, and Performance.
***Must be flexible to work between the business hours of 7 am to 8 pm***
***This position is in our office at 2222 W. Dunlap Ave Phoenix, Arizona***
Primary Responsibilities:
- Registering, educating and supporting the ECHO Advanced Access to Autism Demonstration population and their families through telephonic assessment and expert clinical interventions
- Evaluating health care needs that qualify for the ECHO Advanced Access to Autism Demonstration benefit, and arranging for services and supplies to support the beneficiary's condition
- Collaborating with the Primary Care Provider, Specialty Care Provider, Therapists, DME provider, and other clinical service providers to enhance the quality and efficiency in healthcare delivery to the ECHO Advanced Access to Autism Demonstration population
- Managing the ECHO Advanced Access to Autism Demonstration financial benefit in coordination with the beneficiary/family/Primary & Specialty Health Care Provider in order to maximize the benefit and provide enhanced quality of life
- Document all clinical information in accordance with United Healthcare Military & Veterans policies and procedures in the member's electronic medical record
- Assess and interprets the ECHO Advanced Access to Autism Demonstration population's health care needs, gaps, and requirements and provides referral to other Military and Veteran Case Management programs as indicated
- Provides assessment, coaching, teaching and referral to the ECHO population's family members and caregivers as required
- Identifies and coordinates care with community resources as indicated
- Identifies solutions to military unique, non-standard request and problems
- Solves moderately complex problems and/or conducts moderately complex analyses
- Develops benefit focused care plan in collaboration with family, other Case Managers, Primary Care Provider, Specialty Providers, other service providers as needed to assure ECHO Advanced Access to Autism Demonstration benefit managed according to DoD guidance
- Works with minimal guidance, seeks guidance on only the most complex tasks
- Translates concepts into practice
- Provides explanations and information to others on difficult issues
- Coaches, provides feedback, and guides others
- Collaborates with specialists, physicians, and medical directors to provide the necessary care and cost efficient care for the beneficiary and family
- Assesses the effectiveness and quality of services provided related to clinical, functional, and outcomes
- Coordinates authorizations of services as needed
- Adheres to ethical, legal/regulatory and accreditation standards
Requirements
Required Qualifications:
- Active, unrestricted RN license in the state in which you reside
- 3+ years of experience in a hospital setting, acute care, direct care experience OR experience as a telephonic Case Manager managing complex conditions patients
- United States Citizenship
- Ability to obtain favorable adjudication following submission of Department of Defense
- Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment
- Excellent written and verbal communication skills
- Teamwork skills
- Coaching skills
Preferred Qualifications:
- Bachelor's Degree in Nursing
- 1+ years of Pediatrics
- 1+ years of Home Care
- Autism Case Management
- Work experience with Autism
- Case Management Certification (CCM)
- Prior telephonic case management experience
- Experience in utilization review, concurrent review and/or risk management
- Experience managing financial benefits
- Prior military case management program experience
- Prior experience in start ups
As a requirement of UnitedHealth Group's contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense , (the National Agency Check Legal and Credit or “NACLCâ€). Successful completion of the NACLC process is a requirement for continued employment in this role. NACLC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense. Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received. Failure to obtain final NACLC approval will result in termination from this role.
Careers at UnitedHealthcare Military & Veterans. When it comes to their health care, the men and women who help keep the peace deserve the greatest peace of mind. That's why UnitedHealthcare is the organization that's called on to serve them and their loved ones. We're all about finding better ways to help improve their lives no matter where life may take them. So our career opportunities take challenge to a higher level. If you have a commitment to quality that mirrors our commitment to the men and women of the armed forces, take time to learn more about the career paths available here. It's a genuine opportunity to do your life's best work. (sm)
Diversity creates a healthier atmosphere: 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: Autism, Pediatrics, Peds, RN, Registered Nurse, Nurse, CM, CCM, Phoenix, Arizona, AZ, Case Manager
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