UCare

Care Manager - Connect

7 days left

Employer
UCare
Location
Minneapolis, Minnesota
Posted
Aug 09, 2019
Closes
Aug 26, 2019
Ref
1689
Category
Healthcare
Employment Status
Full Time
Health Care that Starts with You!

Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.

UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.

Rewards

Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.

At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

www.ucare.org/careers/

EOE/AA

ABOUT UCARE
UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.
WORKING AT UCARE
Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.
Our strong culture has established UCare as a Star Tribune Top 150 Workplace for 10 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.

CARE MANAGER - CONNECT

Position Description
This position is accountable for the engagement of members, member's provider care team and to coordinate services across the continuum of health care to meet the health and/or social service needs of members in the assigned Government plan product(s). The case manager provides a full complement of case management services, including but not limited to comprehensive health risk assessments, development of treatment plans, managing member's health care needs, offering pertinent member services with primary care clinics/providers, care systems, specialists, clinic, county, and UCare personnel to achieve the most appropriate and cost-effective member care to optimize the long term health of the member with targeted interventions grounded in evidence based medicine.

• Collaborate with treatment providers, county and community agencies, and contracted and non-contracted providers to identify and coordinate provision of health care services for Government plan product members. Appropriately apply clinical case management criteria, protocols and procedures.

• Understand and accurately interpret and apply relevant contractual requirements, policies, procedures and regulations for members which care management is a provided service.

• Utilize clinical skills to identify and assess care needs and communicate/collaborate with members and/or family members, primary care physicians, clinic staff, providers, and other relevant agencies to assure appropriateness of service that meets member needs and ensures desired outcomes.

• Complete comprehensive health risk assessment of assigned members timely in accordance with all required regulations. Appropriately utilize interpreter services as needed. Identify and monitor member needs, including needed preventive medical care, and significant changes in condition which may warrant early intervention for medical problems. Develop comprehensive, member centric care plans to meet member's individual needs. Incorporate ethnic and culturally appropriate approaches to care planning. Ensure members, providers and all UCare care management service providers assisting with the case are aware of the plan of care.

• Present information on assigned members at assessment conferences and case reviews as appropriate. Enter member information in the clinical documentation system, Care Enhance Clinical Management (CCMS) software. Complete accurate, thorough and timely required documentation.

• Meet and maintain all established caseload and performance metrics, including but not limited to completion ofmodel of care training and passing subsequent competency test. Caseload metrics are determined by employer and may be subject to change at employer's discretion. Failure to complete and pass model of care training competency testing may result in the need to complete additional training and testing. If competency standards are not met following additional training and testing further action may be taken, up to and including termination of employment.

• Ensure safe transitions when members move from one setting to another (i.e. being discharged from a hospital or skilled nursing facility). Ensure the plan of care is communicated between the sending and receiving settings for both planned and unplanned transitions. Support members and member families through care transitions between various facilities, acute and/or chronic settings, and community-based living situations including home.

• Use appropriate communication tools per contractual and care model requirements.

• Monitor and report all quality of care issues through the appropriate internal or external systems.

• Assist with CMS Star Rating initiatives or HEDIS quality initiatives and project improvement planning as appropriate.

• Attend internal and external meetings, including staff meeting, discharge planning conferences, community meetings.

• Provide back-up coverage for other care managers as assigned.

• Other projects and duties as assigned.

Education
B.S. in nursing or B.A. in social work or related field. Registered Nurse with a nursing diploma (3 year program) or associate degree in nursing with five or more years of experience also considered. Current Minnesota license as an RN or social worker is required. Licensure requirements may depend on assigned product(s).
Required Experience
3+ year's experience in care coordination/case management across the continuum of health care (hospital, clinic, nursing home, home care etc.) with primary emphasis in working with complex social and medical problems.
Experience in home health care a plus.
Preferred Experience
Managed care experience, experience with government programs, particularly Medicare, Medicaid and other State Public Programs.Experience working with multi-cultural populations desired.

Certified Public Health Nurse in the state of MN preferred.

THE UCARE DIFFERENCE
The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.
As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

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