Explore opportunities with SunCrest Home Health , a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources. Primary Responsibilities: Clinical Competence Initiates, develops, implements, and revises the plan of care in collaboration with the physician and other health care professionals Supervises care provided by home health aides and licensed practical/vocational nurses, provides instruction, and assigns tasks according to State and federal regulations Provides required supervisory visits Documentation and Care Delivery Provides high-quality clinical services within the scope of practice and infection control standards, in accordance with the plan of care, and in coordination with other health care team members Completes comprehensive assessments (OASIS) including medication reconciliation accurately and timely Documents patient visits per policy and payer requirements, and syncs timely per LHC policy Quality Makes initial and/or comprehensive nursing evaluation visits, ensures patients meet home health eligibility and medical necessity guidelines, determines primary focus of care, develops the plan of care within State guidelines with the physician, and submits accurate documentation Communicates relevant information timely and effectively with appropriate agency staff, including patient care issues, visit assignments, schedule changes, orders, OASIS data sets, coding requests, and coordination with other clinicians Communicates timely and effectively with physicians, patients, and family members to ensure quality care and service excellence Teamwork Takes direction from Clinical Director and Executive Director professionally and completes assigned tasks timely, including required learning Assists in the orientation of new agency personnel and serves as a preceptor to other staff and students Actively participates in survey/survey readiness activities and performance improvement plans, works to reduce unnecessary patient hospitalizations, improve patient safety, and implements processes and best practices to ensure positive patient outcomes Participates in on-call and weekend rotation as needed to meet patient needs Adheres to and participates in the agency's utilization management model 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 RN licensure in state of practice Current Driver's License, vehicle insurance, and access to a dependable vehicle or public transportation Current CPR Certification Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client Preferred Qualifications: Ability to work independently Solid communication, writing, and organizational skills 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 $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable #LHCJobs 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.
Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Case Manager is responsible and accountable for coordination of patient services through an interdisciplinary process, which provides a clinical and psychosocial approach through the continuum of care. Through concurrent case management, patients will be assessed to determine appropriateness of admission, continued hospitalization, as well as appropriate level of care. Discharge planning will begin at the time of (or prior to) admission, and reassessed ongoing throughout the course of hospitalization. Quality and Risk Management issues will also be monitored and reported as appropriate. CM may be assigned to various units throughout the hospital or the Emergency Department. Primary Responsibilities: The CM will be responsible for integrating the assessment of the need for post-hospital services and determination of an appropriate discharge plan for complex cases Educates patient/family as to options/choices within the level of care determined to be appropriate. Initiates and ensures completion of all necessary paperwork Facilitates completion of orders as required prior to transfer of patient to the next level of care in a timely manner so discharge is not delayed Continuum of Care planning will emphasize education and collaboration with physicians, family members, clinical social workers, nursing staff, therapists and case managers from contracted payors when appropriate to determine discharge plan that will be of maximum benefit to the patient. Involve staff from the next level of care in the treatment plan as early as possible to promote continuity and collaboration Reports on all relevant information to the staff assuming responsibility for the next level of care Employees are expected to comply with all regulatory requirements, including CMS and Joint Commission Standards Knowledge of all applicable federal and state regulations. Demonstrates a working knowledge of managed care and Medicare health plans as well as reimbursement related to post-acute services within the continuum of care Consults with physician section leaders for support in cases where continued stay is not appropriate, and case managers are unable to come to resolution by working with assigned physician Responsible for communicating with the department director LOS and financial information, as well as issues that may affect the Continuum of Care process All employees are expected to remain flexible to meet the needs of the hospital, which may include floating to other departments to assist as the patient's needs fluctuate Reviews the patient plan of care with the multi-disciplinary team. Facilitates and participates in multi-disciplinary team care conferences for patients with complex problems. Communicates in the medical record and verbally with the team to coordinate interventions and facilitate continuity of care Daily communication and collaboration with the patient care staff to provide continuous assessment, evaluation and continuum planning to ensure the patient receives the appropriate level of care at the appropriate time Coordinates patient care processes to achieve desired quality outcomes and identifies/controls inappropriate resource utilization Facilitates patient and family education and promotes continuity of care to achieve optimal patient outcomes. Assures patient rights by offering a choice when appropriate Professional Accountabilities: Adheres to name badge/dress code compliance Effectively solves problems and actively pursues resolution Directly communicates with staff, physicians, patients and families in a professional and courteous manner Role models leadership behavior through courtesy, respect and efficiency Functions without direct supervision, utilizing time constructively and organizing assignments for maximum productivity. Arrange schedule to facilitate meetings with physicians for patient care rounds, team meetings and other opportunities to improve communication You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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, active, unrestricted RN license in Colorado 2+ years of experience working as a clinician in an acute care setting with proficient knowledge of hospital workflows Live in the Boulder, CO regional area (this position is location based and not open to remote work) Willing and able to work Per Diem onsite at our office location in Boulder CO (at least 2 weekend shifts per month and holiday rotations) Preferred Qualifications: Case management experience or certification Solid clinical acumen with the ability to use sound judgment, deductive reasoning, and problem-solving skills Demonstrates a high level of organization with the ability to stay focused on the detail Demonstrates collaborative skills and ability to interact with people of diverse backgrounds Solid written and verbal communication skills Self-motivated and able to function in a fast-paced work environment Meets and maintains quality and productivity standards Solid working knowledge of Microsoft packages Ability to learn and understand various clinical software applications Proficient typing skills Effectively solves problems and actively pursues resolution Critical thinking and organizational skills Knowledge or understanding of community resources, policies, and procedures 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 $28.94 to $51.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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. #RPO #RED
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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together . The Senior Clinical Quality of Care RN will be responsible for conducting quality of care (QOC) investigation, review and management of the regulatory Incident/Accident/Death (IAD) portal, documenting and communicating findings from these reviews, and preparing reports or summaries for internal and external customers. This position collaborates with the Chief Medical Officer or other Medical Directors to review QOC and other investigations and ensures that QOC investigations comply with all applicable State, Federal, and regulatory requirements. These activities are used to ensure care and services provided to our members are timely, adequate, and compliant with regulatory and professional standards and guidelines. These QOC investigations are specific to Arizona Medicaid and Medicare members. This position is an Arizona based remote position with the option of working 40% in-office. There is travel up to 25% of the time based on business needs. In-office may be required based on performance metrics. The office is located at 1 East Washington Street in Phoenix. If you are located within the state of Arizona, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities Perform clinical documentation review of inpatient and outpatient care delivered to adults and children with Medicaid, Medicare health care benefits through Arizona United Health Care Community Plans for peer review and internal investigations of Quality of Care concerns Create professionally written case investigation summaries for Peer Review, present case summaries at the Provider Advisory Committee as applicable Review plans of correction from providers in response to a substantiated QOC occurrence Effectively interface with external customers, facilities and providers to resolve quality of care concerns, obtain medical records and other information Conduct delegated oversight reviews of contractors that perform work on behalf of UnitedHealthcare. This includes reviewing samples of contractor work against an audit tool or information found in medical charts Collaborate internally with Medical Directors and staff in other UHCCP departments Manage multiple tasks and projects and changing priorities; prioritize work products effectively Maintain timeliness for deliverables and regulator requests Must have the ability to work independently, good critical thinking skills, excellent verbal and written communication skills Occasional on-site provider visits may be required for potential Quality of Care concerns 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 RN license in the state of Arizona 5+ years of experience working as a Registered Nurse 2+ years of hospital experience as a Registered Nurse Experience evaluating and auditing medical records Proven intermediate skills in Microsoft Office, Word, and Excel ability to work with multiple data bases to retrieve and enter information Ability to travel up to 25% within the state of Arizona Driver's license and access to reliable transportation Reside within the state of Arizona Preferred Qualifications Quality Management experience in a healthcare setting Experienced with Behavioral Health Services Experience analyzing information and preparing written summaries Experience working in a deadline driven environment prioritizing responsibilities Knowledge of Medicare/Medicaid regulations Experience with medical record review and identification of quality of care concerns 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 $35.00 to $62.50 per hour based on full-time employment. We comply with all minimum wage laws as applicable. #UHCPJ 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.
$5,000 Sign-on Bonus for External Candidates 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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. You push yourself to reach higher and go further. Because for you, it's all about ensuring a positive outcome for patients. In this role, you'll work in the field and coordinate the long-term care needs for patients in the local community. And at every turn, you'll have the support of an elite and dynamic team. Join UnitedHealth Group and our family of businesses and you will use your diverse knowledge and experience to make health care work better for our patients. In this Health and Social Services Care Coordinator role, will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs. If you are located on Maui, HI, you will have the flexibility to work remotely* as you take on some tough challenges. Position requires travel about 75% of the time locally. Primary Responsibilities Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team Visit our members in their homes or in long-term care facilities. You'll need to be flexible, adaptable and, above all, patient in all types of situations 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, unrestricted RN license in the state of Hawaii 2+ years of experience working within the community health setting OR in a health care related role Experience working directly or collaborating services for long-term care, home health, hospice, public health or assisted living Intermediate level of proficiency with MS Word, Excel and Outlook Willing or ability to travel in assigned region to visit Medicaid members in their homes and/or other settings, including community centers, hospitals or providers' offices Current access or ability to obtain internet access via a landline Driver's license and access to reliable transportation Preferred Qualifications Bachelor's degree or higher CCM (Certified Case Manager) Case Management experience Experience with or exposure to discharge planning Experience with utilization review, concurrent review and/or risk management Experience with electronic charting Experience with arranging community resources Experience as a Public Health Nurse Field-based work experience Background in managing populations with complex medical or behavioral needs Background in mental health or experience working with serious mental illness 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 $28.27 to $50.48 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. #UHCPJ
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 In this Health and Social Services Coordinator role, will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs. Our team is made up of RNs, Social Workers, Behavioral Health Specialists and others dedicated to helping members achieve their health care goals. This is a Field Based role with a Home-Based office. If you are located in or within commutable driving distance to College Station or Bryan, TX or surrounding areas, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team Visit Medicaid members in their homes and/or other settings, including community centers, hospitals, or providers' offices 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, unrestricted RN license in the State of TX 4+ years of experience working within the community health setting or in a health care role Intermediate Microsoft Office experience working with Microsoft Word, Excel, and Outlook (ability to create, edit, save and send documents, spreadsheets and emails) High speed internet at residence Valid driver's license, reliable transportation and the ability to travel up to 75% in assigned region to visit Medicaid members in their homes and/or other settings, including community centers, hospitals, nursing facilities or providers' offices Reside in or within commutable driving distance from College Station or Bryan, TX area Preferred Qualifications PDPM certification or the ability to obtain within 30 days of employment Experience in case management and/or certification in case management (CCM) Field-based work experience Experience with electronic charting Proven background in managing populations with complex medical or behavioral needs Bilingual skills: English and Spanish Reside in College Station or Bryan, TX area 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 $28.94 to $51.63 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.
