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Telephonic RN Care Coordinator for WellMed
Help our patients live healthier lives
No nights or on-call!
The schedule for this position is Tuesday - Saturday 8am to 5pm
The Telephonic RN Care Coordinator is responsible for successfully supporting all members enrolled in the HealthRight Disease Management Programs with high-risk diagnoses such as Diabetes, CHF, IHD, and COPD/Asthma. The RN acts as an educator, resource, and advocate for members and their families to ensure a maximum level of independence. The RN will interact and collaborate with a multidisciplinary care team, which includes physicians, nurses, case managers, social workers and other educators to develop educational strategies and care management interventions that will assist in maximizing patient outcomes.
Essential Job Functions
- Possess planning, organizing, conflict resolution, negotiating, collaborative and interpersonal skills to be used telephonically.
- Performs telephonic member evaluations to establish educational and care management needs and provide effective educational techniques.
- Remains knowledgeable about related high-risk diagnoses such as Diabetes, CHF, IHD, and COPD/Asthma.
- Assist in providing patient empowerment through use of motivation, supportive skills, problem solving, and self-management goal setting.
- Collaborates with multidisciplinary care team including physicians, nurses, case managers, social workers and other educators/health coaches to identify and provide effective education techniques for plan member.
- Evaluates effectiveness of teaching methods and provides feedback, recommendations and corrective action plans to the multidisciplinary care team for ensure patient progression toward goals.
- Provide member enrollment into qualifying programs such as, but not limited to: Medication Voucher Programs, Diabetic supplies, Diabetic shoes.
- Ensures all new initiatives, policies and procedures, guidelines or other necessary updates are incorporated into patient educational program to provide reconciliation and/or verification of status, conditions and/or medications.
- Manages patient case load in an efficient and effective manner utilizing time management skills to facilitate the total work process.
- Provides constructive information to minimize problems and increase customer satisfaction.
- Seeks ways to improve job efficiency and makes appropriate suggestions following the appropriate chain of command.
- Enters timely and accurate data into Disease Management and UM applications
- following NCQA guidelines for Disease Management documentation as needed to communicate patient needs.
- Follows plan for professional development and actively seeks out opportunities to increase
- knowledge and expertise in nursing education.
- Maintains knowledge of health plan benefits and provider network.
- Participates in the development of appropriate QI processes, establishing and monitoring
- Performs all duties for internal and external customers in a timely and responsible manner representing the company with the utmost professionalism.
- Performs all other related duties as assigned.
- Graduate of an Associates Degree Nursing (ADN) Program with a current license to practice in the applicable State
- Diverse clinical experience with five or more years experience in caring for the acutely ill patients with multiple disease conditions
- Possess planning, organizing, conflict resolution, negotiating and interpersonal skills
- Proficient in PC software computer skills such as Microsoft Word, Excel, Power Point, and other departmental specific programs/applications
- Independent problem identification/resolution and decision making skills
- Must be able to prioritize, plan, and handle multiple tasks, demands simultaneously
Preferred Education, Experience & Skills
- BSN degree with current RN license to practice in the applicable State
- Experience working with psychiatric and geriatric patient population
- Bilingual (Spanish)
WellMed is a healthcare delivery system serving more than 90,000 patients, primarily Medicare eligible seniors, in Texas and Florida through primary care clinics, multi-specialty clinics, and contracted medical management services. Headquartered in San Antonio, Texas, WellMed is an industry leader in medical risk management, highly effective disease management and chronic care programs, healthcare delivery services and more.
Our focus and mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. We are innovators in preventative healthcare, striving to change the face of healthcare delivery for seniors. Our providers and support staff are selected for their dedication to the senior population and focus on preventative, proactive patient care.
WellMed is now part of the OptumHealth division under the greater UnitedHealth Group umbrella.
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.
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.
keywords: rn, registered nurse, telephonic nurse, disease managment, case managemnt, san antonio, tx
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Job Category: Nurse
Job Reference Code: UHG-555766
Position Type: Full-Time