1+ months

RN, Practice Performance Consultant - Field Based in Eastern Pennsylvania

Philadelphia, PA 19107
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Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)


Primary Responsibilities:

  • Provides care coordination/case management through physician practices for members to improve clinical quality and clinical documentation; no direct patient care

  • Assist members in overall wellness and health prevention

  • Conduct telephonic member needs assessments according to state and national guidelines, policies, procedures, and protocols

  • Interact with patients via telephone; Schedule appointments, Follow-up calls to assess understanding of services, answer questions and ascertain that additional procedures have been completed

  • Review member charts prior to a physician appointment and create alerts/triggers to highlight Star opportunities for the practice

  • Partner with the practice's administrative and clinical staff while managing patient appointments and data between visits

  • Create and maintain a professional and supportive relationship with the patient, provider and office staff

  • Facilitate appropriate member referrals to special programs such as Behavioral Health, Advanced Illness and Social Services

  • Assist the member to access community, Medicare, family and other third-party resources as appropriate

  • Collaborate and communicates with the member's health care and service with our interdisciplinary delivery team to coordinate the care needs for the member

  • Provide education to members regarding health care needs and available services

  • Utilize critical thinking skills to assist members in removing barriers to closing Star gaps

  • Facilitate member compliance with their care/treatment plan and to ensure continuity of care

  • Identify barriers to optimal care and outcomes or clinical concerns and communicate with members and providers to formulate action plan to address

  • Document all care coordination activities and interventions in the member's health plan clinical record

  • Maintain a focus on timely, high-quality customer service and the confidentiality of all sensitive information

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.



Jobs Rated Reports for Registered Nurse

Posted: 2020-08-12 Expires: 2020-10-08

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, Practice Performance Consultant - Field Based in Eastern Pennsylvania

UnitedHealth Group
Philadelphia, PA 19107

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Registered Nurse
118th2018 - Registered Nurse
Overall Rating: 118/220
Median Salary: $70,000

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