For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) The Nurse Care Manager serves as a key member of the UnitedHealthcare Global Team (UCHG) utilizing evidenced based practice to assess UHCG member's medical care needs, treatment plans of healthcare providers and the ability of the local healthcare systems to provide high quality and cost effective care in various countries across the world. UHCG Nurse Care Manager also works collaboratively with the UHCG Medical Director and internal team members to establish and implement plans for the patient's safe evacuation to a location where appropriate care is available when it is determined that care needs cannot be met in the patient's location. Working together with the Medical Director the UHCG Care manager facilitates seamless provision of healthcare services to individual members helping them live healthier lives wherever they may be located across the globe.Primary Responsibilities:Triage of global medical cases, including assessment and communication of case direction to the logistics specialist related to continued monitoring of care being provided locally or the need for evacuationAlong with the UHCG Medical Director the RN Care Manager works collaboratively with international and domestic healthcare providers and internal colleagues to assure high quality cost-effective care management, proactive discharge planning, optimize reduce readmission risk and optimize patient healthInitiates and maintains verbal and/or electronic communication with all appropriate stakeholders (patients, providers and clients) related to the status and action plans for the caseAdheres to clinical documentation standards to ensure efficient case review, communication with team members and to facilitate timely and efficient determinations and claims adjudicationParticipates in the management of complex medical cases and collation of clinical information to assess and expedite assessment of care needs. This includes obtaining and reviewing verbal and written medical reports/recordsPro-actively engages UHCG Medical Director to review, discuss and develop solutions for complex member situationsParticipates in routine team meetings, training and ongoing educational activities as well as policy and procedure developmentEngages in provider and facility quality assurance review, policy and procedure development as determined by business need
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.