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Hours Full-time, Part-time
Location Lihue, HI
Lihue, Hawaii

About this job

Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. This is the place to do your life's best work.(sm)



As a Field-Based Case Manager, you'll wear many hats, and work in a variety of environments. You will be responsible for clinical operations and medical management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating. This includes coordination of services, disease management, and medical management consulting. You will also be responsible for providing health education, coaching and treatment decision support for members. Field Service Coordinators work in the community providing proactive home visits and service coordination to individuals and support to their families.


What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.



 


***Field based position on Kauai with a home office***


 


***Must live on Kauai and have established relationships in the community***


  


Primary Responsibilities:





  • Making visits to conduct face to face assessments of member needs in their homes in the Kauai community


  • Making outbound calls to follow up on members' current health status and needs

  • Identifying gaps or barriers in care plans or service plans

  • Providing patient education to assist with self management

  • Interacting with Medical Directors on challenging cases

  • Coordinating  services for members

  • Making referrals to outside resources

  • Coordinating services as needed (home health, DME, etc)

  • Educating members on disease processes

  • Encouraging members to make healthy lifestyle changes

  • Documenting and tracking findings

  • Utilizing criteria to determine if patients are in the least restrictive environment in which they can receive services 


  • Conducting post hospital assessments and adjustments to the service plan and plan of care to ensure that the discharged member receives the necessary services and resources

Requirements

Required Qualifications:



  • Current, unrestricted RN license in the State of Hawaii

  • A minimum of 2 years experience in a hospital setting, acute care, home hospice, direct care experience, including case management

  • Intermediate/Advanced computer proficiency including MS Word and Excel

  • Strong communication skills, written and verbal

  • Strong organizational skills and multitasking abilities

  • Must have a reliable vehicle, current and unrestricted driver's license and proof of auto insurance

  • Ability to get a high-speed Internet connection at home and a work space where privacy and confidentiality can be maintained

 


Preferred Qualifications:



  • BSN

  • A background in managed care

  • Certified Case Manager (CCM)

  • Experience/exposure with discharge planning

  • Experience in utilization review, concurrent review and/or risk management

  • Experience with home health, hospice or long term care is highly preferred

  • Experience as a Public Health Nurse

 


Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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, 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.


 


Job Keywords: RN, Registered Nurse, Case Manager, CCM, Medicaid, Kapaa, Kauai, HI, Hawaii