Clinical Care Advocate - Honolulu, HI - QUEST Program RN at Honolulu

Job Description

For those who want to invent the future of health care, heres your opportunity. Were going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your lifes best work.(sm)The Clinical Care Advocate supports assigned practices with on site care coordination to facilitate appropriate primary care visit planning, follow up and coordination to reduce adverse events for high risk/Health Home cohort patients. The Clinical Care Advocate coordinates with practice clinical teams and United teams/resources to ensure high risk patients receive optimal care at each visit.Responsibilities:Work on site with assigned Medical Homepractice clinical team supporting the clinicalteam in managing cohorts of high risk/home health members to ensure they are seen by their PCP as needed and meet goals.Work with the PCP to ensure that all aspects of the patient plan of care is followed.Plan for each PCP visit, prep the PCP, meet the cohort patients before scheduled practice visits and complete medication reconciliation. Prep PCP by providing lists of current care opportunities, information on medication compliance, updates on referral results and other priority issues.Follow up with specialists to ensure referrals to specialist appointments are completed and specialist visit documentation is provided to PCPon time,and the patient returns for a primary care follow up visit.Review Medical Home Registry updates daily to identify any unplanned ER visits or Admissions for High Risk Cohort patients and coordinate to return patient to primary care within 7 days.Coordinate support for patients using available United care management ICCT resources and local Promotoras for education and outreach.Collaborate with the practice Medical Home clinical team to identify and address barriers to closing current care opportunities.Collaborate with local hospital UM nurse and transition nurse for transitional needs of high risk patients in medical home practices.Use the Medical Home Population Registry for High Risk patients to plan visits, track follow up and ensure open care opportunities are addressed.Report daily, weekly and monthly measurable progress on high risk patients to clinical teams and at JOC.

Job Requirements

REQUIREMENTS:Registered Nurse (RN)with active and unrestrictedlicense in the state ofHawaiiA minimum of 2 years of RN experience working within a clinic or practice setting, including case coordinationReliable transportation to travel toProvideroffices, facilitiesandother locationsDemonstrated ability to usea PC in a Windows environmentAdditional Assets:Previous experience workingin PediatricsStrong understanding of the Medicaid system in HawaiiGuided Care Nurse CertificationExperience caring for patients with chronic conditionsUnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. If youre ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach. This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth 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, Quest, Medicaid, Medicare, Care Advocate, clinic, practice, Pediatrics
Country: USA, State: Hawaii, City: Honolulu, Company: UnitedHealth Group.