1+ months

RN Office Navigator - Marrero, LA - 892735

Marrero, LA 70072
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What you do matters. And who you do it for matters even more. If you're looking for more meaningful impact, you should take a serious look at our growing organization. Since our founding in the mid-90's, Peoples Health has brought innovation and compassion to Medicare patients throughout Louisiana. Now, part of the UnitedHealth Group family of companies, our team consists of over 900 people who are experienced in all aspects of care delivery, health maintenance and administrative support. It's our goal to help guide over 60,000 Medicare recipients across the broad spectrum of health and dental services. We're committed to the highest purpose; improving lives. And that makes us the singular place todo your life's best work.(sm)

TheOffice Navigator, as a part of the primary care patient centered medical home team, engages in a collaborative process, which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet a member's health needs through communication and available resources to promote quality, cost effective outcomes. The Office Navigator is responsible for ensuring a member's encounter with providers, office staff, and Peoples Health is seamless and comprehensive. The Office Navigator will review, plan, and coordinate health care services in order to utilize appropriate processes and appropriate resources to improve member's health outcomes.

Primary Responsibilities:

  • Identifies and communicates community and Peoples Health departmental concerns to the appropriate department
  • Understands Peoples Health plans, assists members with appropriate utilization of their benefits and provides answers to plan related questions
  • Assists member with scheduling appointments with the primary care provider (PCP), specialists', referrals, follow-up testing and/or office procedures
  • Assists members to make optimal use of their primary care provider's office encounters
  • Coordinates services requiring authorizations and ensures appropriate documents are submitted
  • Prior to scheduled appointment with the primary care provider, conducts pre-visit planning by reviewing data in People Health systems and the PCP's electronic medical record (EMR)
  • Creates a "fact pack" for the provider by identifying HEDIS/Star measures needed, reviews current and past medication record, and current services being provided
  • Utilizes and documents appropriate referrals to coordinate needed resources for member; i.e. pharmacy, durable medical equipment (DME), social services, home health, chronic care improvement, etc. Submits appropriate documentation to support referral
  • Ensures receipt, review and documentation of test and treatment results
  • Maintains accurate documentation in the member's medical record
  • Communicates post-hospital discharge visits and documents services and protocols appropriately needed and requested
  • Within seven (7) days following post-hospital discharge, coordinates with other team members, to perform medication reconciliation and alert provider to any issues and/or discrepancies
  • Receives, reviews, and shares with primary care provider's office manager, the monthly HEDIS/Star measures report in order to coordinate an action plan for improved measure performance and outcomes for the members
  • Provides a business card for future coordination and communication with providers
  • Assists with other 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:

  • Licensed RN, eligible to practice in the State of Louisiana

  • 2+ years of experience in clinical setting

  • Experience with clinical documentation systems

  • Experience in assessing members and developing care plans

  • You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role

  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

  • Bachelor's degree in Nursing

  • Disease management, chronic care improvement and/or quality improvement experience in a managed care setting

  • Experienced in managed care industry setting

  • Understanding of HMO and third-party administration

  • Understanding of nursing home and long term acute care regulations

Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)

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.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: People's Health, RN, Louisiana, Gretna, New Orleans, Care Manager, Office Navigator, Clinical, EMR, LA,Marrero,Louisiana


Jobs Rated Reports for Registered Nurse

Posted: 2020-10-23 Expires: 2020-12-25

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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RN Office Navigator - Marrero, LA - 892735

UnitedHealth Group
Marrero, LA 70072

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Registered Nurse
122nd2019 - Registered Nurse
Overall Rating: 122/199
Median Salary: $71,730

Work Environment
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