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in Colorado Springs, CO
TRICARE Community Nurse RN Case Manager - Colorado Springs, CO - Full-time / Part-time
Hours | Full-time, Part-time |
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Location | Colorado Springs, CO Colorado Springs, Colorado |
About this job
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. Talk about meaningful work. What an important role. Our UnitedHealthcare Military & Veterans organization has been selected to provide quality health care services for those who serve our nation. Make your last career change one of inspiration. Find out more about these opportunities to do your life's best work.(sm)
UnitedHealthcare Military and Veteran have an excellent opportunity available to join our company as a Community Nurse (RN) Case Manager. As a Community Nurse Case Manager, you will be responsible for working with a multidisciplinary team providing clinical case management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating. This position provides both in-home, hospital based and telephonic case management and education in support of TRICARE beneficiaries. Our mission is to help people live their lives to the fullest. We live our values are Integrity, Compassion, Relationships, Innovation, and Performance.
Candidate must live within a 40 mile radius of Fort Carson
Primary Responsibilities:
- Educating and supporting the individual through face-to-face and telephonic assessment and expert clinical management interventions
- Evaluating delays in care, coordinates with Utilization Management team facilitating discharge planning, and arranging for alternative care services to facilitate timely and appropriate discharge
- Documenting all clinical information in accordance with UnitedHealthcare Military & Veterans policies and procedures in the member's electronic medical record
- Assess and interprets beneficiary needs, gaps, and requirements related to his/her disease condition
- Develops CM care plan in collaboration with beneficiary/caregiver/provider in order to promote optimal health
- Collaborates with specialists, physicians, and medical directors to provide the necessary care and cost efficient care for the beneficiary related to their condition
- Assesses the effectiveness and quality of services provided related to clinical, functional, and outcomes
- Consulting and collaborating with Behavioral Health CM colleagues on Bio/Psycho/Social assessments and service plans in a multidisciplinary team
- Adheres to all ethical, legal/regulatory and accreditation standards
Requirements
- Current unrestricted RN license in the state of residence
- 2-3 years experienced in community delivery of care (home care/ hospice/ Community care management)
- At least 5 years of experience in a hospital setting, acute care, outpatient direct care experience OR experience as a telephonic Case Manager managing disease conditions
- Case Management Certification- or ability to achieve in 18 months
- United States Citizenship
- Ability to obtain favorable adjudication following submission of Department of Defense
- Knowledge of managed care principles
- Strong computer skills
- Behavioral health/ substance abuse experience helpful
- Successful candidates will be highly organized and possess excellent communication skills
- Unrestricted driver's license
- BSN preferred
- Knowledge or Military or Veterans experience preferred
- Field based role which requires local travel within an assigned geographical territory, assessments and follow-up visits will be completed face to face. When not working in the field, work will be completed from a home based office