Skilled Inpatient Care Coordinator - Athens, TX

If you are within a 20-mile commutable distance of 711 Lukas Drive, Athens, TX, 75751, including the ability to attend on – site for 1 – 2 days a week, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges. Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental, and social needs – helping patients access and navigate care anytime and anywhere. As a team member of our naviHealth product, we help change the way health care is delivered from hospital to home supporting patients transitioning across care settings. This life-changing work helps give older adults more days at home. We’re connecting care to create a seamless health journey for patients across care settings. The Skilled Inpatient Care Coordinator plays an integral role in optimizing the patient’s recovery journey. The Skilled Inpatient Care Coordinator is responsible for reviewing continued stay authorization requests for skilled nursing and rehabilitative services and determining if requests meet medical necessity for the requested level of care. The position coordinates the transition of patients from the community or acute setting to the next appropriate level of care while following established facility policies and procedures. This position is full-time, Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of  8:00 AM – 5:00 PM CST. It may be necessary, given the business need, to work occasional overtime or an early or late shift and / OR longer than normal hours to accommodate peaks in volume of work. Our office is located at 711 Lukas Drive, Athens, TX, 75751. Employees will be required to work 1 – 2 days on – site and some days from home. We offer 7- 8 weeks of paid on-the-job training (2 weeks of virtual training and once completed, 5 – 6 weeks of mentorship program with another individual in the same role). The hours during training will be 8:00 AM – 5:00 PM CST from Monday – Friday. *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. 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 Review targets for Length of Stay (LOS), target outcomes, and discharge plans with providers and families 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. Manager or Medical Director Assure appropriate referrals are made to the Health Plan, High – Risk Case Manager, and / or community – based services Attend patient / family care conferences Coordinate peer to peer reviews with naviHealth Medical Directors Support new delegated contract start – up to ensure experienced staff work with new contract Enter timely and accurate documentation into the CM Tool application Adhere to organizational and departmental policies and procedures 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. Flexibility and willingness to work an early or late shift and / OR longer than normal hours to accommodate peaks in volume of work ~ Ability to work any of our full-time, 8-hour shift schedules during our normal business hours of 8:00 AM – 5:00 PM CST from Monday – Friday ~ Must be 18 years of age OR older CMS knowledge ~ Managed care experience ~ Experience in acute care, rehab, OR skilled nursing facility environment ~ Experience with performing clinical audits to improve quality standards OR performance Telecommuting Requirements: Reside within a 20-mile commutable distance of 711 Lukas Drive, Athens, TX, 75751, including the ability to attend on – site for 1 – 2 days a week Ability to keep all company sensitive documents secure (if applicable) Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Strong technical / computer skills Ability to manipulate laptop computer (or similar hardware) between office and site settings Ability to view screen and enter data into a laptop computer (or similar hardware) within a standard time period Ability to communicate with clients and team members including use of cellular phone or comparable communication device At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. 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.