Skilled Inpatient Care Coordinator - Navihealth - Austell, Ga

The Skilled Inpatient Care Coordinator (SICC) plays an integral role in optimizing patients’ recovery journeys. The SICC completes weekly functional assessments and engages the PAC inter-disciplinary care team providing them with the proprietary nH Outcome tool to align expectations for discharge planning. The position engages patients and families to share information and facilitate informed decisions. By serving as the link between patients and the appropriate health care personnel, the SICC is responsible for ensuring efficient, smooth, and prompt transitions of care.

Primary Responsibilities:

• Assure appropriate referrals are made to the Health Plan, High-Risk Case Manager, and/or community-based services
• Manage assigned caseload in an efficiently and effectively utilizing time management skills
• Adhere to organizational and departmental policies and procedures
• Review monthly dashboards, readmission reports, quarterly, and other reports with the assigned Clinical Team Manager, as needed, to assist with the identification of opportunities for improvement
• Assure patients’ progress toward discharge goals and assist in resolving barriers
• Support new delegated contract start-up to ensure experienced staff work with new contract
• Attend patient/family care conferences
• Participate weekly in SNF Rounds providing accurate and up to date information to the naviHealth Sr. Manager or Medical Director
• Review targets for Length of Stay (LOS), target outcomes, and discharge plans with providers and families
• Perform other duties and responsibilities as required, assigned, or requested
• Perform Skilled Nursing Facility (SNF) assessments on patients using clinical skills and appropriate measurement tools, such as nH Predict, nH Outcome, InterQual and CMS criteria, upon admission to SNF and periodically through the patient stays
• When naviHealth is delegated for utilization management, review referral requests that cannot be approved for continued stay and are forward to licensed physicians for review and issuance of the NOMNC when appropriate
• Assess and monitor patients’ continued appropriateness for SNF setting (as indicated) according to InterQual criteria or the nH Outcome
• Coordinate peer to peer reviews with naviHealth Medical Directors
• Collaborate effectively with the patients’ health care teams to establish an optimal discharge. The health care team includes physicians, referral coordinators, discharge planners, social workers, physical therapists, etc
• Engage with patients, families, or caregivers either telephonically or on-site weekly and as needed
• Maintain confidentiality of all PHI information in compliance with HIPPA, federal and state regulations, and laws
• Complete all SNF concurrent reviews, updating authorizations on a timely basis
• Enter timely and accurate documentation into the CM Tool application
• Daily review of census and identification of barriers to managing independent workload and ability to assist others

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:

• Proficient with Outlook, Excel and Word
• 3+ years of clinical experience
• Active, unrestricted registered clinical license - Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Therapist

Preferred Qualifications:

• 2+ years of Case Management experience
• Proven solid problem solving, conflict resolution, and negotiating skills
• Patient education background, rehabilitation, and/or home health nursing experience
• Experience working with geriatric population
• Demonstrated exceptional verbal and written interpersonal and communication skills
• Proven ability to be a team player
• Proven ability to prioritize, plan, and handle multiple tasks/demands simultaneously
• Proven independent problem identification/resolution and decision-making skills
• Proven ability to be detail-oriented

Work Conditions and Physical Requirements:

• Ability to view screen and enter data into a laptop computer (or similar hardware) within a standard period of time
• Ability to communicate with clients and team members including use of cellular phone or comparable communication device
• Ability to establish a home office workspace
• Ability to remain stationary for extended time periods (1 - 2 hours)
• Ability to mobilize to and within sites within an assigned local or regional market/area, including car transport, up to 85% of the time
• Ability to manipulate laptop computer (or similar hardware) between office and site settings

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

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.