Nursing Facility Care Manager - Western, VA Markets

Requisition number: 2336898

Job category: Medical & Clinical Operations

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

The Nursing Facility Care Manager is responsible for facilitating, promoting, and advocating for the enrollees' ongoing self-sufficiency and independence. This position is responsible for assessment and planning for an identified group of patients in Nursing Facilities. Additionally, the care coordinator is responsible for assessing the availability of natural supports such as the enrollee's representative or family members to ensure the ongoing mental and physical health of those natural supports.

The Nursing Facility Care Manager collaborates with the Interdisciplinary Team to coordinate the delivery of comprehensive, efficient, cost-effective patient care. The Nursing Facility Care Manager will be traveling into nursing facilities, Adult Day Health, and Adult Living Facilities (ALF) to conduct in-depth assessments and develop the plan of care.

The Nursing Facility Care Manager actively assists enrollees with care transitions in collaboration with the Interdisciplinary Team and the acute or skilled facility staff, and the enrollees and / or the enrollees' representatives. The Nursing Facility Care Manager act as liaison between the Health Plan, the Commonwealth, enrollees, and their families.

The Nursing Facility Care Manager follows established professional standards of care, Commonwealth guidelines and policy and procedures.

This is a field-based position visiting Nursing Facilities based in Western VA Markets.

For consideration, you must reside within a commutable distance of Washington County, Grayson County and Smyth County VA Markets Alleghany or Rockbridge Counties in VA.

If you reside within a commutable distance of Washington, Grayson and Smyth County, VA, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs

• Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines

• Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan

• Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health

• Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission

• Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Current and unrestricted Licensed Practical Nurse in the state of Virginia OR Social Work or Human Services (or related field) with a 4-year degree

• 3+ years of care coordination or behavioral health experience and/or work in a healthcare environment

• 1+ years of experience with MS Office, including Word, Excel, and Outlook

• Experience working with members who have medical needs, the elderly, individuals with physical disabilities and / or those who may have communication barriers

• Driver's license and reliable transportation and the ability to travel within assigned territory to meet with members and providers

Preferred Qualifications:

• CCM certification

• Experience working with Medicaid / Medicare population

• Experience working in team-based care

• Long term care / geriatric experience

• Background in Managed Care

Physical Requirements:

• Ability to transition from office to field locations multiple times per day

• Ability to navigate multiple locations/terrains to visit employees, members and/or providers

• Ability to transport equipment to and from field locations needed for visits (ex. laptop, stethoscope, etc.)

• Ability to remain stationary for long periods of time to complete computer or tablet work duties

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.89 to $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.