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The Post-Acute Case Manager functions as part of the primary care team, and reports to the Supervisor, Post-Acute Case Management. The Case Manager supports the team by performing activities as outlined below, and as assigned by the Supervisor of the team. The Case Manager performs activities that fall within the scope of practice. This role works in close collaboration within a transdisciplinary team and may support multiple providers. Case Manager completes assessments, coordinates transitions of care, supports treatment plans, and completes case documentation in the electronic medical record and other health plan specific required duties as assigned. This position is field-based.
Primary Responsibilities:
- Engage OptumCare Arizona- members in eligible clinical services during skilled nursing facility admission
- Work closely with health partners, members and the interdisciplinary care team to facilitate appropriate discharge planning
- Travel to designated skilled nursing facilities throughout Maricopa County, Arizona
- Participate in weekly interdisciplinary team meeting at the skilled nursing facility
- Perform utilization management, utilization review, or concurrent review (onsite or telephonic)
- Coordination and assurance of appropriate levels of care to members
- Collaborate with the care team to meet patient-centric affordability goals and quality outcomes
- Ensuring regulatory compliance requirements are met
- Responsible for providing medical management services, including case management, psychosocial assessments, and interventions to aid patients in improving their wellbeing
- May identify, coordinate or provide appropriate levels of care under the direct supervision of an RN or MD
- Other duties, as assigned
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 Master of Social Work license in the state of Arizona (LMSW, LCSW) or Current, unrestricted registered nurse (RN) license in the state of Arizona
- Demonstrated knowledge of utilization management, quality improvement, discharge planning with transitions of care
- Experience working with Medicare members
- Proven working knowledge of hospice and palliative care
- Proven working knowledge of skilled nursing facilities & long term acute care facilities
- Proven planning, organizing, conflict resolution, negotiating and interpersonal skills
- Ability to autonomously prioritize, plan, and manage multiple tasks/demands simultaneously
- Experience with Microsoft Office
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.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
