naviHealth, part of Optum and the UnitedHealth Group family of businesses, combines the talents of our dedicated staff and leading-edge technology to deliver compassionate care to seniors nationwide. With millions of lives touched, we are innovating the way health care is delivered from hospital to home so seniors can lead more fulfilling lives. A career with us means making an impact in the lives of those we serve, including vulnerable populations who benefit from care that is more efficient, more effective and more human. Our environment empowers our team members to elevate our interactions with each other and the experiences we deliver to our patients, giving them more days at home.
The Skilled Inpatient Care Coordinator (SICC) plays an integral role in optimizing patients’ recovery journeys. The SICC completes weekly functional assessments and engages the PAC inter-disciplinary care team providing them with the proprietary nH Outcome tool to align expectations for discharge planning. The position engages patients and families to share information and facilitate informed decisions. By serving as the link between patients and the appropriate health care personnel, the SICC is responsible for ensuring efficient, smooth, and prompt transitions of care.
Primary Responsibilities:
- Perform Skilled Nursing Facility (SNF) assessments on patients using clinical skills and appropriate measurement tools, such as nH Predict, nH Outcome, InterQual and CMS criteria, upon admission to SNF and periodically through the patient stays
- Review targets for Length of Stay (LOS), target outcomes, and discharge plans with providers and families
- Complete all SNF concurrent reviews, updating authorizations on a timely basis
- Collaborate effectively with the patients’ health care teams to establish an optimal discharge. The health care team includes physicians, referral coordinators, discharge planners, social workers, physical therapists, etc.
- Assure patients’ progress toward discharge goals and assist in resolving barriers
- Participate weekly in SNF Rounds providing accurate and up to date information to the naviHealth Sr. Manager or Medical Director
- Assure appropriate referrals are made to the Health Plan, High-Risk Case Manager, and/or community-based services
- Engage with patients, families, or caregivers either telephonically or on-site weekly and as needed
- Attend patient/family care conferences
- Assess and monitor patients’ continued appropriateness for SNF setting (as indicated) according to InterQual criteria or the nH Outcome
- When naviHealth is delegated for utilization management, review referral requests that cannot be approved for continued stay and are forward to licensed physicians for review and issuance of the NOMNC when appropriate
- Coordinate peer to peer reviews with naviHealth Medical Directors
- Support new delegated contract start-up to ensure experienced staff work with new contract
- Manage assigned caseload in an efficiently and effectively utilizing time management skills
- Enter timely and accurate documentation into the CM Tool application
- Daily review of census and identification of barriers to managing independent workload and ability to assist others
- Review monthly dashboards, readmission reports, quarterly, and other reports with the assigned Clinical Team Manager, as needed, to assist with the identification of opportunities for improvement
- Adhere to organizational and departmental policies and procedures
- Maintain confidentiality of all PHI information in compliance with HIPPA, federal and state regulations, and laws
- Perform other duties and responsibilities as required, assigned, or requested
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:
- Active, unrestricted registered clinical license - Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Therapist
- 3+ years of clinical experience
- Proficient with Outlook, Excel and Word
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Preferred Qualifications:
- 2+ years of Case Management experience
- Experience working with geriatric population
- Patient education background, rehabilitation, and/or home health nursing experience
- Exceptional verbal and written interpersonal and communication skills
- Solid problem solving, conflict resolution, and negotiating skills
- Independent problem identification/resolution and decision-making skills
- Detail-oriented
- Ability to prioritize, plan, and handle multiple tasks/demands simultaneously
- Team player
Work Conditions and Physical Requirements:
- Ability to establish a home office workspace
- Ability to manipulate laptop computer (or similar hardware) between office and site settings
- Ability to view screen and enter data into a laptop computer (or similar hardware) within a standard period of time
- Ability to communicate with clients and team members including use of cellular phone or comparable communication device
- Ability to remain stationary for extended time periods (1 - 2 hours)
- Ability to mobilize to and within sites within an assigned local or regional market/area, including car transport, up to 85% of the time
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity 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.