TRICARE Community Nurse (RN) Case Manager San Diego, CA
Location: San Diego California
Description: UnitedHealth Group is at the momment seeking for TRICARE Community Nurse (RN) Case Manager San Diego, CA right now, this career will be placed in California. More details about this career opportunity please read the description below. UnitedHealthcare Military and Veteran have an excellent opportunity available to join our company as a Community Nurse (RN) Ca! se Manager in the San Diego market. As a Community Nurse Case Manager, you will be responsible for working with a multidisciplinary team providing clinical case management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating. This position provides both in-home and telephonic case management and education in support of TRICARE beneficiaries. Our mission is to help people live their lives to the fullest. We live our values are Integrity, Compassion, Relationships, Innovation, and Performance.
Primary Responsibilities:
Educating and supporting the individual through face-to-face and telephonic assessment and expert clinical management interventions
Evaluating delays in care, coordinates with Utilization Management team facilitating discharge planning, and arranging for alternative care services to facilitate timely and appropriate discharge
Documenting all clinical information ! in accordance with UnitedHealthcare Military & Veterans polici! es and procedures in the member's electronic medical record.
Assess and interprets beneficiary needs, gaps, and requirements related to his/her disease condition
Develops CM care plan in collaboration with beneficiary/caregiver/provider in order to promote optimal health
Collaborates with specialists, physicians, and medical directors to provide the necessary care and cost efficient care for the beneficiary related to their condition
Assesses the effectiveness and quality of services provided related to clinical, functional, and outcomes
Consulting and collaborating with Behavioral Health CM colleagues on Bio/Psycho/Social assessments and service plans within an integrated multidisciplinary team.
Adheres to all ethical, legal/regulatory and accreditation standards
Current unrestricted RN license in the state of CA
BSN preferred
Case Management Certification- or ability to achieve in 18 months
At least 5 years of experience in a hospit! al setting, acute care, outpatient direct care experience OR experience as a telephonic Case Manager managing disease conditions
Experienced in community delivery of care (home care/ hospice/ Community care management 2-3 years) highly preferred
United States Citizenship
Ability to obtain favorable adjudication following submission of Department of Defense form SF86 NAC form SF86
Knowledge of managed care principles
Strong computer skills
Behavioral health/ substance abuse experience helpful
Knowledge or Military or Veterans experience preferred
Successful candidates will be highly organized and possess excellent communication skills
Unrestricted driver’s license
Physical Requirements:
Field based role which requires local travel within an assigned geographical territory, assessments and follow-up visits will be completed face to face. When not working in the field, work will be completed from a home based offic! e
As a requirement of UnitedHealth Group’s contract wit! h the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 http://www.opm.gov/forms/pdf_fill/sf86.pdf, (the National Agency Check or â€Å"NACâ€Â). Successful completion of the NAC process is a requirement for continued employment in this role. NAC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense. Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received. Failure to obtain final NAC approval will result in termination from this role.
Careers at UnitedHealthcare Military & Veterans. When it comes to their health care, the men and women who help keep the peace deserve the greatest peace of mind. That’s why UnitedHealthcare is th! e organization that’s called on to serve them and their loved ones. We’re all about finding better ways to help improve their lives no matter where life may take them. So our career opportunities take challenge to a higher level. If you have a commitment to quality that mirrors our commitment to the men and women of the armed forces, take time to learn more about the career paths available here. It’s a genuine opportunity to do your life’s best work.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Key Words: Field Nurse, RN, Home Health, Hospic! e, Home care, community care, Nurse, San Diego, California
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This career starts available on: Tue, 10 Sep 2013 12:03:42 GMT
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