UnitedHealth Group Sr RN MDCP Case Manager - West Houston, TX in Houston, Texas
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)
The Sr. Field RN Case Manager for the TX STAR Kids Program will manage the care of members in their homes or other community settings by completing in-person health assessments and coordinating patient care, focusing on disease management and keeping members healthy and independent.
If you are located in Central to west Houston, you will have the flexibility to telecommute* as you take on some tough challenges. Travel 75% of the time.
Travel 75% of the time.
Engaging members / families in their homes or in a facility to coordinate services, community resources and treatment needs
Travel in assigned territory as needed to complete member assessments; the rest of the time will be spent working in a home-based office
Delivering a holistic approach to coordinated care based on the member’s needs using a person centered approach
Ensure LTSS and clinical programs are in place according to members wants and needs to include functional, medical, behavioral and social needs
Support members desires to live in the least restrictive setting as possible
Assist members with the transition from a care facility back to their home
Identifying early risk factors and conducting ongoing assessments and documenting in an electronic file
Completes all initial and annual service planning activities, and verifies, authorizes, coordinates and monitors services
Creating, reviewing and revising care plans and focusing on a holistic approach
Functioning as an advocate for member
Collaborating with the member's PCP to deliver and coordinate necessary services
Building relationships with members and their families; assisting them with coordination of health choices
Ensuring cases are documented in a timely manner
Coordination with other state agencies, community resources and providers
RN License, must be current and unrestricted in state of Texas
RUG certification or the ability to obtain within 30 days of employment
3 + years of recent experience as a RN in pediatrics including developmental challenges of the pediatric population
High Speed Internet access in home
Strong computer proficiency to include the ability to use Microsoft Word, Outlook and Internet on a daily basis
Access to reliable transportation and willingness to travel throughout surrounding area on regular basis
Bachelor's Degree or Higher
Experience with Medicare and / or Medicaid
MDCP (Medically Dependent Children's Program) experience
Case Management experience
Managed care experience
Experience with complex populations
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)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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.
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