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Case Manager Licensed Practical Nurse - Oklahoma City, OK
| Hours | Full-time, Part-time |
|---|---|
| Location | Oklahoma City, OK Oklahoma City, Oklahoma |
About this job
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.
Employees in this position will work as an
extension of the local Provider Care teams by aligning to geographical regions
and physician practices that care for a high volume of Medical & Retirement
membership, as well as coordinating all facets of patients' needs.
Primary Responsibilities:
- Review all member charts prior to a physician
appointment and create alerts/triggers to highlight Star opportunities for the
Provider. - Partner with the Practice's Administrative and
Clinical staff while managing patient appointments and data between visits. - Assist members in navigating their network of
Providers by assisting with follow-up and Specialist appointments as
needed. - Assist with Program Eligibility verifications.
- Appropriate Referrals to Case Management
staff. - Interact with patients via telephone; Schedule
appointments. - Perform Data collection, Data Entry and
Quality monitoring activities, as applicable. - Document case information completely,
accurately, and in a timely manner. - Demonstrate sensitivity to issues and show
proactive behavior in addressing customer needs. - Provide ongoing support and education to team
members. - Optimize customer satisfaction, and positively
impact productivity. - Will not conduct any evaluation or
interpretation of Clinical data and will be supervised by Licensed and/or
Certified staff. - Adhere to corporate requirements related to
industry regulations/responsibilities. - Maintain confidentiality and adhere to HIPAA
requirements. - Other duties, as assigned.
Requirements
- High School Diploma/GED.
- Current and Unrestricted LPN license in the State of OK.
- 25% - 75% Travel to provider offices and member homes within the service deliver area (up to 1-hour radius).
- 2+ years of Telephonic Customer Service experience.
- 1+ year of a healthcare background with Medical Terminology.
- 1+ year of working experience with ICD-9 and CPT codes.
- 1+ year of working experience with Microsoft Word and Excel.
- 1+ year of working experience with HIPAA compliance requirements.
- Reliable transportation, valid insurance, and valid & unrestricted driver's license within the State of OK.
- Data Entry skills, with a typing speed of at least 45 - 50 WPM.
- Experience working in a Physician, Provider, and/or Medical Office.
- EMR knowledge and experience.
- HEDIS knowledge and experience.
- Experience with navigating and analyzing reports in Microsoft Excel.
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.