Sign In
 [New User? Sign Up]
Mobile Version

Field Based HEDIS RN - Gwinnett County Georgia

UnitedHealth Group


Location:
Lawrenceville, GA
Date:
08/18/2017
2017-08-182017-09-16
Job Code:
1779591
Apply on the Company Site
  •  
  • Save Ad
  • Email Friend
  • Print
  • Research Salary

Job Details


Field Based HEDIS RN - Gwinnett County Georgia(Job Number:727979)
Description

Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. This is the place to do your life's best work.(sm)

 

This position will be working out of provider offices throughout Gwinnett County. You will be responsible to review charts (paper and electronic - EMR), look for gaps in care, perform assessments, help coordinate doctor appointments, make follow-up calls to members after appointments, and assist our members in overall wellness and prevention. You will be working at the provider office on a daily basis. This position is Monday - Friday during business hours. 

 

Primary Responsibilities:
  • Provides care coordination / case management through physician practices for members to improve clinical quality and clinical documentation - No direct patient care
  • Conducts telephonic member outreach for needs assessments according to state and national guidelines, policies, procedures and protocols
  • Interacts 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  
  • Facilitates appropriate member referrals to special programs such as Behavioral Health, Advanced Illness and Social Services
  • Assists the member to access community, Medicare, family and other third-party resources as appropriate
  • Collaborates and communicates with the member’s health care and service with our interdisciplinary delivery team to coordinate the care needs for the member
  • Provides education to members regarding health care needs and available services
  • Works to facilitate member compliance with their care / treatment plan and to ensure continuity of care
  • Identifies barriers to optimal care and outcomes or clinical concerns and communicate with members and providers to formulate action plan to address
  • Documents all care coordination activities and interventions in the member’s health plan clinical record
  • Maintains a focus on timely, high-quality customer service
  • Maintains the confidentiality of all sensitive information

Job Case Management
Primary Location US-GA-Lawrenceville
Other Location US-GA-Norcross, US-GA-Duluth
Organization RQNS Ops
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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.

Powered By

Featured Jobs[ View All ]

Featured Employers [ View All ]