US - Indiana - Merrillville
June 17, 2024
Opportunities at WellMed , part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind
• Caring. Connecting. Growing together.
•
The WellMed Quality Clinical Programs team supports WellMed Medical Management by delivering patient-centered, clinically collaborative telephonic outreach to help people live healthier lives. Our team focuses on the design, execution, and delivery of telephonic and digital engagement strategies designed to close STARs measure gaps in care, e.g. medication adherence, care for older adults, medication reconciliation post discharge, A1c, etc. Our interdisciplinary service delivery team is comprised of Registered Nurses, Licensed Vocational Nurses, and Social Workers.
The Registered Nurse will report into the Manager of Clinical Programs. The Registered Nurse will perform telephonic, patient-centered clinical consults focused on Care for Older Adults annual pain and functional assessments. In addition, the RN will outreach telephonically for Transition of Care following hospital discharge to complete reviews as well as assist with appointment scheduling. The RN will be required to meet or exceed established productivity and quality metrics and work a flexible schedule to support the hours of operation of the business
You ll enjoy the flexibility to work remotely
• from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Strictly adheres to department s metrics and established advanced protocols and to handle incoming contacts including, but not limited to, prescription refill requests, lab results, x-ray results, medical inquiries, patient education and referral requests
Primarily to make outbound calls but occasionally help manage the inbound call queue from patients, patient representatives, providers and other medical staff, while strictly adhering to established protocols and scripting
Review patient chart (in EMR) to ensure core measures are being addressed and met per protocol and takes appropriate action when they are not, i.e., schedule services
Complete patient assessments for Transition of Care Medication Reconciliation Post Discharge, Care for Older Adults Pain and Function Assessments
Educate patients on health conditions and necessity of route screening but assisting with appointment scheduling (A1c, Breast Cancer Screening, Colorectal Cancer Screening, Diabetic Eye Exam, etc.)
Communicate with providers and offices to obtain needed evidence of completed lab work, screenings and care provided
Review available medical records for core measures to submit for closure of HEDIS/STARS measures
Assist patients with identification of and connectivity to community and program resources to assist with non-medical needs, (Pharmacy assistance programs, meals on wheels, LIS)
Document thoroughly all calls and actions taken within core systems
Mon-Fri 8am-6pm Central and Required Rotating - Saturdays 8am-5:30pm Central. Hours of Operations
Performs all other related 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:
Active, unrestricted Registered Nurse license in
4+ years of RN experience, including experience in a managed care setting
2+ years of experience in HEDIS/Star programs, preferably in a clinical quality consultant role.
2+ years of call center experience
2+ years of experience with data analysis and/or quality chart reviews. Must be able to review paper and electronic medical records and charts
Proven solid knowledge of the Medicare HEDIS/Stars measures
Demonstrated ability to interact with medical staff, peers, and internal company staff at all levels
Ability to manage multiple complex, concurrent projects
Proven excellent written and verbal communication and relationship building skills
Demonstrated solid problem-solving skills; the ability to analyze problems, draw relevant conclusions and devise and implement an appropriate plan of action
Experienced using Microsoft office applications, including databases, word-processing, outlook, and excel spreadsheets. Must be proficient in Excel
Proven excellent customer service skills and communication skills
Preferred Qualifications:
Undergraduate degree or post graduate degree
Billing and CPT coding experience
Clinical data abstraction experience
Adaptable to change
Good business acumen, especially as it relates to Medicare
Bilingual/Vietnamese
• All employees working remotely will be required to adhere to UnitedHealth Group s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you ll find a far-reaching choice of benefits and incentives.
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: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.
UnitedHealt.
United States - IN - IN - Kendallville
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified PCU RN in Indiana! • Pay Information • $2,889 per week • About The Position Next Move, Inc. is looking for PCU/IMC RNs to fulfill an assignment in Bloomington, Indiana. Benefits • Medical, Dental, Vision, and 401K within the...
United States - IN - IN - Osceola
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified Med/Surg RN in Indiana! • Pay Information • $3,051 per week • About The Position Next Move, Inc. is looking for Med/Surg RNs to fulfill an assignment in Indianapolis, Indiana. Benefits • Medical, Dental, Vision, and 401K...
United States - IN - IN - Corunna
April 19, 2024
Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly...
United States - IN - IN - Columbus
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified Med/Surg RN in Indiana! • Pay Information • $2,725 per week • About The Position Next Move, Inc. is looking for Med/Surg RNs to fulfill an assignment in Indianapolis, Indiana. Benefits • Medical, Dental, Vision, and 401K...
United States - IN - IN - Jasper
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified Med/Surg RN in Indiana! • Pay Information • $2,725 per week • About The Position Next Move, Inc. is looking for Med/Surg RNs to fulfill an assignment in Indianapolis, Indiana. Benefits • Medical, Dental, Vision, and 401K...
United States - IN - IN - Elkhart
June 17, 2024
SkyBridge Healthcare Therapy is seeking a travel Physical Therapist for a travel job in Elkhart, Indiana. & Requirements • Specialty: Physical Therapist • Discipline: Therapy • Start Date: 07/01/2024 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type: Travel SkyBridge...
United States - IN - IN - Shelbyville
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified Med/Surg RN in Indiana! • Pay Information • $3,051 per week • About The Position Next Move, Inc. is looking for Med/Surg RNs to fulfill an assignment in Indianapolis, Indiana. Benefits • Medical, Dental, Vision, and 401K...
United States - IN - IN - Bedford
June 16, 2024
SkyBridge Healthcare Therapy is seeking a travel Physical Therapy Assistant for a travel job in Bedford, Indiana. & Requirements • Specialty: Physical Therapy Assistant • Discipline: Therapy • Start Date: 07/01/2024 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type:...
United States - IN - IN - Washington
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified PCU RN in Indiana! • Pay Information • $2,889 per week • About The Position Next Move, Inc. is looking for PCU/IMC RNs to fulfill an assignment in Bloomington, Indiana. Benefits • Medical, Dental, Vision, and 401K within the...
United States - IN - IN - Bloomington
June 17, 2024
SkyBridge Healthcare Therapy is seeking a travel Physical Therapist for a travel job in Bloomington, Indiana. & Requirements • Specialty: Physical Therapist • Discipline: Therapy • Start Date: 07/01/2024 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type: Travel...
United States - IN - IN - Bloomington
May 28, 2024
TravelNurseSource is working with Host Healthcare to find a qualified PCU RN in Bloomington, Indiana, 47408! • Pay Information • $1,813 to $1,966 per week • About The Position • Host Healthcare is an award-winning travel healthcare company with an immediate opening for this Registered Nurse - PCU in...
United States - IN - IN - Mishawaka
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified PCU RN in Indiana! • Pay Information • $2,889 per week • About The Position Next Move, Inc. is looking for PCU/IMC RNs to fulfill an assignment in Bloomington, Indiana. Benefits • Medical, Dental, Vision, and 401K within the...
United States - IN - IN - Plymouth
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified Med/Surg RN in Indiana! • Pay Information • $3,051 per week • About The Position Next Move, Inc. is looking for Med/Surg RNs to fulfill an assignment in Indianapolis, Indiana. Benefits • Medical, Dental, Vision, and 401K...
United States - IN - IN - Logansport
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified PCU RN in Indiana! • Pay Information • $2,889 per week • About The Position Next Move, Inc. is looking for PCU/IMC RNs to fulfill an assignment in Bloomington, Indiana. Benefits • Medical, Dental, Vision, and 401K within the...
United States - IN - IN - Griffith
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified Med/Surg RN in Indiana! • Pay Information • $3,051 per week • About The Position Next Move, Inc. is looking for Med/Surg RNs to fulfill an assignment in Indianapolis, Indiana. Benefits • Medical, Dental, Vision, and 401K...
United States - IN - IN - Danville
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified Med/Surg RN in Indiana! • Pay Information • $3,051 per week • About The Position Next Move, Inc. is looking for Med/Surg RNs to fulfill an assignment in Indianapolis, Indiana. Benefits • Medical, Dental, Vision, and 401K...
United States - IN - IN - Zionsville
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified PCU RN in Indiana! • Pay Information • $2,889 per week • About The Position Next Move, Inc. is looking for PCU/IMC RNs to fulfill an assignment in Bloomington, Indiana. Benefits • Medical, Dental, Vision, and 401K within the...
United States - IN - IN - Bedford
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified Med/Surg RN in Indiana! • Pay Information • $3,051 per week • About The Position Next Move, Inc. is looking for Med/Surg RNs to fulfill an assignment in Indianapolis, Indiana. Benefits • Medical, Dental, Vision, and 401K...
United States - IN - IN - Merrillville
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified PCU RN in Indiana! • Pay Information • $2,889 per week • About The Position Next Move, Inc. is looking for PCU/IMC RNs to fulfill an assignment in Bloomington, Indiana. Benefits • Medical, Dental, Vision, and 401K within the...
United States - IN - IN - Hobart
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified Med/Surg RN in Indiana! • Pay Information • $3,051 per week • About The Position Next Move, Inc. is looking for Med/Surg RNs to fulfill an assignment in Indianapolis, Indiana. Benefits • Medical, Dental, Vision, and 401K...
United States - IN - IN - Indianapolis
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified Med/Surg RN in Indiana! • Pay Information • $2,725 per week • About The Position Next Move, Inc. is looking for Med/Surg RNs to fulfill an assignment in Indianapolis, Indiana. Benefits • Medical, Dental, Vision, and 401K...
United States - IN - IN - Hudson
April 19, 2024
Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly...
United States - IN - IN - Mongo
April 19, 2024
Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly...
United States - IN - IN - Plainfield
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified Med/Surg RN in Indiana! • Pay Information • $2,725 per week • About The Position Next Move, Inc. is looking for Med/Surg RNs to fulfill an assignment in Indianapolis, Indiana. Benefits • Medical, Dental, Vision, and 401K...
United States - IN - IN - Frankfort
June 17, 2024
SkyBridge Healthcare Therapy is seeking a travel Certified Occupational Therapy Assistant for a travel job in Frankfort, Indiana. & Requirements • Specialty: Certified Occupational Therapy Assistant • Discipline: Therapy • Start Date: 07/01/2024 • Duration: 13 weeks • 40 hours per week • Shift: 8...
United States - IN - IN - Angola
April 19, 2024
Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly...
United States - IN - IN - La Porte
June 6, 2024
TravelNurseSource is working with Next Move Healthcare to find a qualified Med/Surg RN in Indiana! • Pay Information • $3,051 per week • About The Position Next Move, Inc. is looking for Med/Surg RNs to fulfill an assignment in Indianapolis, Indiana. Benefits • Medical, Dental, Vision, and 401K...