Lvn Case Manager Wellmed, Corpus Christi, Tx - Now Hiring

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 Patient Navigator (PN) enhances navigation through the complexity of hospital admissions for patients and providers as dedicated patient-care facilitators without clinical responsibilities integrated as full members of the inpatient care team responsible for enhancing communication between and among patients and providers.  This position will be under the general guidance of the Administrator responsible for inpatient hospital service. 

Primary Responsibilities:

• Reconcile inpatient census with hospitalists and Trucare information
• Assist hospitalists to obtain medical records from outside entities including accurate medication list, specialist consults, hospital records, and any other records requested
• Obtain follow up appointments with primary care physician, and specialists if applicable, prior to discharge, working with the case management and transitions team to coordinate optimal timing
• Liaison for the hospitalists and patients to the clinic health coaches, triage nurses, clinic administrators and primary care physicians if any information needed from hospital portal
• Obtain accurate medication lists on admission and discharge from inpatient facility. Utilize eCW and ePRG as needed to reconcile information
• Assist with medication delivery to patients prior to discharge through relationships with local pharmacy
• Communicate by phone to patients and families after discharge to identify barriers and issue which could possibly cause readmission while appropriately working with primary care clinic staff to resolve
• Coordinate referrals to Palliative Care Program or hospice when requested
• Follow up with hospital and WellMed Case Managers prior to discharge to ensure discharge planning occurs in a timely manner. Be available to answer questions regarding discharge plan and needs of patient and/or family
• Coordinate medical record requests for outside records as needed by the hospitalist team, utilitizing eCW as appropriate or communicating directly with outside physicians
• Assist with DataRAPs initiative to utilize hospitalist encounters to capture HCC codes, including tracking mechanism to measure success
• Gather data as needed and organize participation in PCC meetings creating better collaboration between primary care physicians and hospitalists
• Assist with completion of patient satisfaction surveys for the providers on the hospitalist team including data entry into the appropriate database
• Work with the administrator and hospitalists to identify issues affecting quality, readmissions, leakage, and increased length of stay while working to identify processes to improve
• Monitor quality measures in EPRG to so that when possible metrics can be addressed while in hospital. Understand how to access pink box report and other tools to notify hospital teams of any gaps outstanding for each patient
• Performs 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:

• High School Diploma or GED
• Texas Licensed Vocational Nurse
• Clinical LVN/LPN licensure in TX
• 2+ years of administrative support experience
• Medical terminology knowledge base
• Basic knowledge of Microsoft Office products, including Word and Outlook
• Proven ability to work independently, with some supervision and direction from manager
• Proven ability to maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times
• Proven ability to maintain strict confidentiality at all times to include but limited to patients and coworkers
• Proven ability to comply with all organizational policies regarding ethical business practices
• Proven ability to adhere to all department policies and procedures
• Demonstrated excellent organizational skills, customer service skills, and verbal and written communication skills to include but not limited to patients, physicians, clinical staff, contracted providers and managers

Preferred Qualifications:

• 2+ years of experience in a physician’s clinic or hospital
• Experience working in a medical care setting as a receptionist or medical assistant
• Bilingual language proficiency (English/Spanish)

Physical & Mental Requirements:

• Ability to stand for extended periods of time
• Ability to properly drive and operate a company vehicle

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.

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