Skilled Inpatient Care Coordinator Sewell, NJ - 2198166
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. Join us to start Caring. Connecting. Growing together.
At , our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company’s technical vision and strategy.
The Skilled Inpatient Care Coordinator plays a lead role in optimizing patients’ recovery journeys. By serving as a link between colleagues, patients and the appropriate health care personnel, the SICC is responsible for ensuring efficient and prompt transitions of care for own and other colleagues’ patient responsibilities. The SICC effectively and efficiently maintains assigned caseload. In addition, the SICC assists the CTM by sharing knowledge and expertise with new colleagues, leading projects and driving process improvements.
- 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; attend patient/family care conferences
- Complete all SNF concurrent reviews, updating authorizations on a timely basis and assisting other colleagues as assigned
- Collaborate effectively with the patients’ health care teams (e.g., physicians, referral coordinators, discharge planners, social workers, physical therapists) to establish an optimal discharge
- Assure patients’ progress toward discharge goals and identifies and assists in resolving barriers
- Participate weekly in SNF Rounds and encourages discussion through providing insights using accurate and up to date information to the naviHealth Sr. Manager or Medical Director
- Assure appropriate referrals are made to the Health Plan, High-Risk Case Manager, and/or community-based services
- Engage with patients, families, or caregivers either telephonically or on-site weekly and as needed
- Assess and monitor patients’ continued appropriateness for SNF setting (as indicated) according to CMS Guidelines, InterQual criteria and utilization of the nH Predict Outcome
- 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; performs secondary review for other colleagues when CTM is unavailable
- Coordinate peer to peer reviews with naviHealth Medical Directors and provide recommendations
- Support new delegated contract start-up to ensure experienced staff work with new contracts
- Manage assigned caseload efficiently and effectively while also initiating and participating in other projects/assignments; creates best practice workflow approach for requirements of new plans
- Enter timely and accurate documentation in the nH Coordinate environment
- Daily review of census and barriers to managing independent workload; assists colleagues in doing the same and recommends/implements improvements
- Review monthly dashboards, readmission reports, quarterly, and other reports with the assigned Clinical Team Manager, highlights opportunities for improvement and makes recommendations
- Adhere to organizational and departmental policies and procedures
- Shares expertise/knowledge with team on regular basis (e.g., hosts ‘lunch and learns’)
- Acts as mentor for onboarding new and other colleagues as needed
- Maintain confidentiality of all PHI information in compliance with HIPPA, federal and state regulations, and laws
- Perform other duties and responsibilities as required, assigned, or requested
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.
Years of post-high school education can be substituted/is equivalent to years of experience