Clinical Quality RN - EPSDT Program
Location: Honolulu, Hawaii
Description: UnitedHealth Group is looking of Clinical Quality RN - EPSDT Program right now, this career will be assigned in Hawaii. For complete informations about this career opportunity kindly read the description below. There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of pat! ients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm) UnitedHealth Group has an immediate need for a Clinical Quality RN on our Quality Management & Peformance team in Honolulu, HI.
The Clinical Quality RN identifies, coordinates, and provides appropriate levels of care to children, teenagers, and young adults under the direct supervision of an RN or MD. The Early and Periodic Screening, Diagnostic and Treatment program (EPSDT) is a Medicaid service required for QExA and QUEST members under the age of 21 that provides comprehensive and preventive child health services.
Responsibilities:
Provide health education, coaching, and treatment decision support for children, teenagers, and young adults under the age of 21
Assess, plan, implement, coordinate, monitor, and evaluate clinical operations and medical management activities across the continuum of care
Cond! uct phone calls and/or send letters to providers to discuss is! sues and concerns of members
Provides both training and updates to Service Coordinators and Case Managers and Provider Service Representatives (PSRs), as required
Assess and interpret member needs and requirements
Track and trend established EPSDT processes
Provide trainings to organizations, providers, and other identified groups to improve understanding of the EPSDT program
Provide explanations and information to children, teenagers, and adults concerning difficult issues
Reviews issues/trends, develops interventions when needed, and report relevant issues/trends to the site Quality Management (QM) Committee
Conduct site visits with PSRs to review and address compliance issues
Review, identify, and work with management to resolve any problematic EPSDT issues
Coach, provide feedback, and guide other staff
Keywords: Registered Nurse, Medicaid, Medicare, Quality, Coaching, Treatm! ent Decision Support, RN
Requirements
QUALIFICATIONS:
Current, unrestricted RN license in the State of Hawaii
A minimum of 3 years of clinical experience as an RN
At least 1 year of experience working with pediatric patients
Demonstrated ability to use a PC in a Windows environment
DESIRED ASSETS:
BSN
Clinical Quality experience
UnitedHealth Group is working to create the health care system of tomorrow.
Already Fortune 25, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we’re doing a lot of good.
Through our family of businesses and a lot of inspired individuals, we’re building a high-performance health care system that works better for more people in more ways than ever. Now we’re looking to reinforce our team with people who ! are decisive, brilliant – and built for speed.
Come to ! UnitedHealth Group , and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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If you were eligible to this career, please email us your resume, with salary requirements and a resume to UnitedHealth Group.
Interested on this career, just click on the Apply button, you will be redirected to the official website
This career starts available on: Tue, 16 Apr 2013 17:05:00 GMT
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