RN or SW Field Service Coordinator - Hilo, HI

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)


In this rewarding and challenging role as one of our newest Field Service Coordinators, 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.
 
***We are currently seeking Field Service Coordinators on Hilo, HI***
 
Primary Responsibilities:  



Making visits to conduct face to face assessments of member needs  

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  

Communicate daily with members to meet state regulated guidelines  

Documenting and tracking activities in multiple computer programs at one time  

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   

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

Required Qualifications:


Current, unrestricted RN or Social Worker license in the State of Hawaii
1+ year of clinical or service coordination experience applicable to the managed care population
Strong computer proficiency including the ability to type and talk at the same time and to navigate around a Windows environment
Strong communication skills, written and verbal
Strong organizational skills and multitasking abilities
Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area 
Preferred Qualifications:   

2+ years experience in a hospital setting, acute care, home hospice, direct care experience OR experience as a telephonic Case Manager for an insurance company
BSN
A background in managed care
Case Management experience
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
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: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and 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: RN, Registered Nurse, Case Manager, Social Worker, LCSW, LBSW, LSW, CCM, Quest, Medicaid, Hilo, HI, Hawaii  
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