Universal American is a New York Stock Exchange company with annual revenues of more than $2 billion. Through our family of healthcare companies, we provide health benefits to people covered by Medicare and/or Medicaid. We are dedicated to working collaboratively with healthcare professionals in order to improve the health and well-being of those we serve and reduce healthcare costs.
Well-capitalized and highly entrepreneurial, Universal American has been on the cutting edge of healthcare for more than 21 years. We offer Medicare Advantage plans to people with Medicare. We partner with providers in Accountable Care Organizations that serve people with Original Medicare. And we provide array of healthcare services to states, municipalities, health plans and other entities in the world of Medicaid. In everything we do, we focus on improving the coordination of healthcare through collaboration between payers, providers and patients to achieve the best health outcomes possible.
For more information on Universal American, please visit our website at www.UniversalAmerican.com.
The NY ICM program will provide intensive case management to the highest complexity/risk members as well as transition of care to all members transitioning from acute settings to sub-acute/home settings.
Our goal is to provide intensive care coordination, support and collaboration with members, care givers and providers for high risk populations. We will provide multiple health, functional, social and financial needs to assist with the prevention or decrease the worsening of members’ health condition.
As a Field Support Specialist in Oneida County, you will work in accordance with UAC policies and procedures, provide effective field –based case management and care coordination services to identified high risk patients such that UAC achieves its quality of care, cost and patient satisfaction goals. The primary objective of this position is to work collaboratively with the clinical staff to identify and resolve clinical and social issues to maximize the opportunity that assigned patients can live at home, safely and adhere to their treatment plans. Field Support Specialist will work collaboratively with the clinicians to provide support with care coordination, ongoing home visits, and telephonic outreach to schedule appointments for field based visits and or telephonic appointments. All members of the team including the Field Support Specialist will participate in interdisciplinary team meetings on a weekly schedule facilitated by program manager and medical director.
•Shared responsibilities for field visits to members’ homes, facilities and telephonic outreach.
•Ongoing assessment, intervention and resolution of member’s needs. Includes, but not limited to addressing ADL/IADL, DME, rehab services, transportation, environmental needs. High priority to utilizing existing support system, local and community resources.
•Coordinate in-home supportive services to members based on the recommended care plan activities.
•Assist with coordination of DME equipment, transportation, nutritional services, home based services, and other services that may be pertinent to the member’s care plan.
•Schedule appointments for home visits.
•Schedule provider appointments.
•Participate in the interdisciplinary case reviews for collaborative assessment and coordination planning to ensure quality of care.
•Notify nursing supervisor or case managers of changing or unusual conditions.
•Instruction on how to access program resources and staff, provider and community resources.
•Complete all appropriate documentation in the Plan’s system.
•Take calls from members and providers and give them appropriate information to help expedite services.
•Conduct daily tracking of caseload as assigned.
•Comply with all departmental policies and procedures.
•Participate in departmental and company in-services as appropriate.
•Comply with Customer Service expectations as applicable to the Department and Health Plan.
•Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable, and defined in the Universal American Corporate and department policies.
•Must also comply with UAM Immunization policy and procedure.
•And all other duties assigned by the manager and/or supervisor.
•Problem solving skills with the ability to look for root causes and implementable, workable solutions. “Go getter” approach essential
•Decision-making skills with the ability to investigate and weigh alternatives and select the course of action that provides the greatest benefit to the organization
•Organizational skills with the ability to handle multiple tasks and/or projects at one time
•Time management skills with the ability to prioritize and schedule daily activities for the most efficient use of time
•Creative thinking skills with the ability to ask the needed bigger-picture questions that lead to process and team improvements
•Interpersonal skills with the ability to work in a fast-paced environment and participate as an independent contributor with little supervision or as an active team member depending on the situation and needs
•Professional verbal and written communication skills, with the ability to clearly articulate thoughts and ideas
•Customer service skills with the ability to interact professionally and effectively with providers, third party payers, physicians, and staff from all departments within and outside the Company
•Must have a track record of producing work that is highly accurate, demonstrates attention to detail, and reflects well on the organization
•Associate Degree and higher in a health related field is desired
•Certification as a home health aide, Certified nursing assistant or equivalent is preferred.
•Minimum of 2-3 years providing patient care activities such as home health aide or certified nursing assistant or related activities such as a clinic or hospital setting
•Experience working in a field based setting with prioritization of tasks
•Experience working with Medicare / Medicaid preferred
•Experience working for a health plan a plus
•Personal computer experience should include working with Microsoft Word, Excel, PowerPoint
and Outlook at the intermediate level at a minimum
•Maintains a valid driver’s license for any required facility on-site and home visits
Universal American Corp. is an Equal Opportunity / Affirmative Action Employer and does not discriminate because of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, military veteran status, or any other characteristic protected by law. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce.
Please refer to the Job Description for the qualifications.
Healthcare - Health Services, Managed Care