LTSS Nursing Facility Service Coordinator Level 1*
Harris Health System · Centralia, WA
Job description
Job Summary Responsible for performing telephonic or face-to-face clinical assessments for the identification, evaluation, coordination, and management of member's needs, including physical health, behavioral health, social services and long-term services and supports. Identifies membersfor high-risk complications and coordinates care in conjunction with the member and the health care team. Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. Obtains a thorough and accurate member history to develop an individual care plan. Establishes short- and long-term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs. The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services. May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible. Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management treatment plans. May also assist in problem solving with providers, claims or service issues. Directs and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member by, for example, assigning appropriate tasks to the non-RN clinicians, verifying and interpreting member information obtained by these individuals, conducting additional assessments, as necessary, to develop, monitor, evaluate, and revise the member's care plan to meet the member's needs, and reviewing and providing input on the non-RN clinicians' performance on a regular basis. Assists in meeting member needs by referring members to internal and external resources. Provide follow up with internal and external resources, providers, and state programs. Coordinate with and participate in ICT meetings with Nursing Facility Staff, member, Responsible Party, treating physicians, therapists, and any other applicable parties. Coordinate and assist with the transition to the community through the Money Follows the Person (MFP) process for any member who indicates a desire to leave the nursing facility. Marginal Functions Provide input and/or data to direct supervisor/manager related to any internal or external mandatory audit or reporting. Serve as mentor, subject matter expert or preceptor to new staff. Involved in process improvement initiatives. Assist in problem solving with providers, claims or service issues. Community Health Choice's Core Competencies • Customer Focus • Reliability and Dependability • Honest and Integrity • Change Management • Teamwork • Impact/Influence + Strategic Vision • People/Team Development Minimum Qualifications Education/Specialized Training/Licensure: Requires a current unrestricted RN license in Texas, Graduate of an accredited school of nursing. Bachelors degree in nursing preferred. CCM Work Experience (Years and Area): 3-4 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background. 1 year experience working with population who receive waiver services,1 year experience working with persons with disabilities/chronic conditions and Long-Term Services & Supports. Management Experience (Years and Area): N/A Software Proficiencies: Microsoft Office, Clinical documentation platforms, Internet Other: Local travel required. Reliable transportation with valid driver's license with good driving record
More jobs in Centralia, WA
CDL-A Owner Operator Truck Driver Job (Earn $5,500 - $9,000/Wk)
Hiring Drivers Now · Centralia, WA
Class A Owner Operator Truck Driver Job (Earn $5,500 - $9,000/Wk) Apply today and within 24 hours you'll receive multiple job offers. Earn $5,500 - $9,000/Wkr based on position/location. Simply select the driving job that offers you what is most important. Higher pay, increased benefits or more home-time: You choose. Owner Operator Driver Pay: $5,500 - $9,000/Wk Apply now to receive your job offers!
Customer Services Support Operator
Ampcus · Centralia, WA
Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team. Job Title: Customer Services Support Operator Location(s): Cary, NC (Hybrid: Tuesday-Thursday in office) Description Apply now for the position of Customer Account Order Professional, and you will be responsible for managing customer accounts and ensuring the seamless processing and fulfillment of diagnostic orders. This role focuses on maintaining high levels of customer satisfaction through effective communication, problem-solving, and process management. The ideal candidate will have strong organizational skills, attention to detail, and the ability to work collaboratively with various departments. Your role: • Order Management: • Oversee the entire order-to-delivery process for assigned customer accounts. • Ensure accurate and timely entry of customer orders into the system. • Using dashboards and reports, monitor and track orders to ensure timely delivery and fulfillment. • Customer Relationship Management: • Act as the main point of contact for customer inquiries related to orders including but not limited to written requests and phone inquiries. • Develop and maintain strong relationships with key customer accounts. • Understand process and system complexities to resolve customer issues and concerns professionally in a timely and effective manner. • Understand the customer's internal processes and business needs while delivering solutions within our established processes and business requirements. • Coordination and Collaboration: • Work closely with sales, marketing, logistics, and production teams to coordinate order fulfillment. • Communicate order status, delays, and any issues to customers proactively. • Collaborate with the finance department to resolve any billing or payment issues. • Conduct meetings and presentations to educate healthcare professionals about our processes, systems, and self-service tools. • Data Management and Reporting: • Maintain accurate records of customer orders, accounts, interactions, and transactions. • Generate and act on reports that provide order status, delivery performance, and customer satisfaction. • Analyze order data to identify trends, issues, and opportunities for improvement. • Process Improvement: • Ability to adapt to rapidly changing processes and environments • Identify areas for improvement in the order management process. • Implement best practices to enhance efficiency, accuracy, and customer satisfaction. • Participate in cross-functional projects aimed at improving the overall order-to-cash process. Your expertise: • Education and Experience: • Bachelor's degree in Business Administration, Supply Chain Management, or a related field or equivalent experience. • Minimum of 2-5 years of experience in order management, customer service, or account management. • Skills and Competencies: • Strong understanding of order processing and supply chain management principles. • Proven track record of success in account/customer management. • Strong interpersonal and communication skills, with the ability to build rapport and trust with customers. • Comfortable working in ambiguity: able to adjust priorities quickly, learn fast, and stay productive through frequent change • Brings a positive, solutions-first attitude: stays steady under pressure and helps the team stay grounded during high-volume or high-change periods. • Enjoys special projects and taking ownership: raises hand for new initiatives, testing, documentation, and process fixes • Detail-oriented with strong organizational and time-management skills. • Ability to work independently and as part of a team. • Problem-solving skills with a proactive approach to addressing issues. Preferred qualifications: • Experience in the healthcare or medical device industry. • Proficient in SAP and Microsoft Office Suite (Excel, Word, PowerPoint). • Ability to understand complex healthcare products and services and effectively communicate their value to customers. • Experience in identify problems and trends and successfully implementing solutions, including process improvements and system enhancements. Experience Required: • 0-3 years of customer service experience, or an equivalent combination of education and experience Working Hours: • 08:30 AM - 05:00 PM (Hybrid schedule as noted above). Must-Have Skills: • Excel • Customer service experience • Microsoft platforms • Client management systems • Reporting and analysis Nice-to-Have Skills: • SAP Ampcus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veterans or individuals with disabilities.
Remote Position This position is national remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. 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 PST. It may be necessary, given the business need, to work occasional overtime. We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule or will be discussed on your first day of employment. Primary Responsibilities: • Demonstrate understanding of internal / external factors that may drive caller questions / issues (e.g., recent plan changes, mass mailings, call directing / rerouting, weather emergencies) • Ask appropriate questions and listen actively to identify underlying questions / issues (e.g., root cause analysis) • Gather appropriate data / information and perform initial investigation to determine scope and depth of question / issue • Identify and coordinate internal resources across multiple departments to address client situations, and escalate to appropriate resources as needed • Proactively contact external resources as needed to address caller questions / issues (e.g., providers, labs, brokers) • Utilize appropriate knowledge resources to drive resolution of applicable questions / issues (e.g., websites, CRM tools, Onyx, Siebel, knowledge bases, product manuals, SharePoint) • Identify and communicate steps / solutions to caller questions / issues, using appropriate problem-solving skills and established guidelines, where available (e.g., workarounds, descriptions of relevant processes) • Offer additional options to provide solutions / positive outcomes for callers (e.g., online access to relevant information, additional plan benefits, workarounds for prescription delays) • Make outbound calls to resolve caller questions / issues (e.g., to callers, providers, brokers, pharmacies) • Drive resolution of caller questions / issues on the first call whenever possible (e.g., first-call resolution, one-and-done) • Ensure proper documentation of caller questions / issues (e.g., research conducted, steps required, final resolution) 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. Required Qualifications: • High School Diploma / GED OR equivalent work experience • Must be 18 years of age OR older • 1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools • Health care experience with primary / specialty appointments OR health plans • Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications • Ability to work any of our full time, 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm PST from Monday - Friday, including the flexibility to work occasional overtime given the business need Preferred Qualifications: • Bilingual fluency in English and Spanish • Experience with working in EPIC system • Experience with working in a remote position Telecommuting Requirements: • Ability to keep all company sensitive documents secure (if applicable) • Required to have a dedicated work area established that is separated from other living areas and provides information privacy • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service (UHG requires a wired internet connection: cable, DSL or fiber internet service with Minimum speed standard of 25 Mb download/10-15 Mb upload. Wireless services such as satellite, hot spot, line of sight antenna cannot be used for telecommuting.) • Ability to connect directly into internet - via hard wire (either directly to modem or router) *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16 - $29 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
After Hours Remote On-Call Hospice Nurse (Philadelphia, PA)
i4 Search Group · Centralia, WA
After Hours - Hospice Nurse Case Manager PRN | Philadelphia, PA Overview: Interested in learning about hospice, seeking more money as a second job and/or love working in the night? Read on! We are seeking a compassionate Hospice Nurse Case Manager to join a dedicated interdisciplinary team providing high-quality end-of-life care to patient's in their residence. The ideal candidate is a skilled clinician who thrives on building strong relationships with patients and families, coordinating care plans, and ensuring that each individual's final journey is met with dignity, comfort, and compassion. You'll be joining a passionate teams of physicians, NPs, chaplains, social workers, and aides. This role will work after hours (4:30pm onwards) with full flexibility in amount of hours and days of the week. They will work remotely, and visit patients at their residence if there is an emergency/clinical need. Hourly rate + variable compensation anytime you leave your home! Responsibilities: • Manage a caseload of hospice patients, conducting comprehensive assessments and developing individualized care plans. • Provide direct skilled nursing care and education to patients and caregivers in the home setting. • Coordinate care with physicians, social workers, chaplains, and other members of the hospice team to ensure holistic, patient-centered care. • Monitor patient status and adjust care plans as needed to maintain optimal comfort and symptom management. • Document assessments, interventions, and communications in accordance with state, federal, and agency guidelines. • Serve as a clinical resource and advocate for patients and families, ensuring their physical, emotional, and spiritual needs are met. • Participate in interdisciplinary team meetings and case conferences. Qualifications: • Current Registered Nurse (RN) license in the state of Pennsylvania • Strong clinical assessment, communication, and organizational skills. • Empathetic, patient-centered approach with the ability to support families during emotionally challenging times. • Valid driver's license, reliable transportation • NEW nurses are welcomed to apply, especially those wanting to learn about hospice! Benefits: • Competitive salary and mileage reimbursement • Comprehensive health, dental, and vision insurance • Paid time off and retirement plan options • Ongoing training and professional development opportunities • Supportive and collaborative work environment