The Senior Clinical Admin Consultant RN (CAC) is responsible for providing expertise as a clinical interface or liaison within the company to resolve and prevent issues concerning initiation and delivery of patient care. The CAC applies their field experience, expertise and clinical nursing assessment skills to: verify physician orders for therapy; determine administration method and patient supply requirements with the pharmacy team; determine nursing care needs and source for these services; coordinate care with subcontracted agencies, trouble shooting and resolving clinical issues, work in multiple applications at one time and execute all tasks with a focus on patient-specific needs.
The Senior Clinical Admin Consultant RN also performs other duties as needed based on experience level, including but not limited to implementing Company processes, programs, and new hire training.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:- Provide expertise as an internal clinical resource to operations teams (including other clinicians and subcontracted agencies) for evaluation of patient needs and/or issue resolution, exercising considerable judgment, problem solving skills, and professional knowledge
- Maintain a comprehensive knowledge base of infusion therapies administered in the home, utilizing Company policies, procedures and protocols in addition to all available training resources to ensure understanding of each therapy before initiating/coordinating treatment
- Completes clinical review of patient referral records and or telephonic data collection, including: current and past medical history; vascular access device (VAD) information; physician orders for appropriateness; ICD-10 code review; and documentation of nursing orders for start of care
- Provides timely communication with other company personnel and outside providers, especially physicians and home health agencies, to assure the quality and continuity of patient care
- Establish and maintain positive clinical rapport with subcontracted agencies, patients and their families, working closely with them in the coordination of infusion therapy, education related to self-care and self-administration expectations, and clinical monitoring of patient response to therapy
- Establish and maintain collaborative relationships with outside agencies and organizations that deliver service on behalf of, or in conjunction with, the Company (e.g., subcontracted home health agencies, durable medical equipment providers, other healthcare team members)
- Utilizes Electronic Medical Record (EMR) and documentation systems to clearly communicate patient status during clinical review, coordination of care and ongoing support of patients
- Participate in completion and tracking of timely signed receipt of physician orders (Plan of Treatment and Supplemental Orders)
- Work with patient care coordinators to triage patient calls to assess needs/issues/complaints/concerns: responding with appropriate urgency; thoroughly evaluating all options for addressing patient needs; and completing all required documentation to reflect actions taken
- Support field nursing staff with communication and follow-up required to resolve patient issues/complaints that are reported to the Company
- Maintain current nursing licensure in all states in which patients are serviced, as required by the respective State Boards of Nursing and/or Department of Health
- Comply with all State and Federal regulations and laws, including employee health and safety protections mandated by the Occupational Safety and Health Administration (OSHA), patient privacy and data security required by the Health Insurance Portability and Accountability Act (HIPAA), as well as all home infusion standards of practice
- Serve as a professional representative of the Company when meeting with and/or providing education to external customers, payers and referral sources
- Participate in medical record audits and other performance-improvement related activities as assigned by leadership
- Complete nurse competency yearly and providing educational reinforcement/ongoing assessment as needed to subcontracted agencies
- May be required to work any day or shift as needed
- Other duties as assigned
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:- Active and unrestricted compact licensure as a Registered Nurse (RN) in the state(s) of practice and others as requested
- 2+ years of experience working as an RN in a clinical care setting that contributes to proficiency in infusion therapy (such as medical surgical unit, emergency department, intensive care unit, post-anesthesia care unit, or similar setting)
- 1+ years of experience working with interdisciplinary healthcare teams that included pharmacy, nursing, payers, case managers/discharge planners, physicians, patients and caregivers
- Experience with electronic medical records (EMR) programs and documentation
- Knowledge of and experience with Microsoft Office
- Proven willing and able to work with an interdisciplinary team of professionals including pharmacists and technicians, physicians and other licensed prescribers, registered dietitians, home health agencies (HHAs), sales representatives, and others as needed to provide comprehensive care and support of patients and caregivers
- Proven willing and able to work independently in home
- Proven willing and able to assume a flexible work schedule in meeting attendance, and other reliability requirements of the position
- Proven effective teaching skills
- Proven effective interpersonal communications, both written and verbal
- Proven excellent organizational and critical thinking skills
Preferred Qualifications:- Infusion Therapy and/or Home Health Agency experience with specific proficiency in infusion therapy
- Experience within a healthcare organization providing coordination and navigation of patient care between providers
- Knowledgeable of HIPAA patient privacy and data security requirements, OSHA employee protection regulations, and The ACHC's accreditation standards for home health and home infusion pharmacy (and other relevant accrediting organizations, as applicable)
- Knowledge of and/or experience with current state licensure requirements
- Knowledge of the Infusion Nursing Society (INS) standards of practice, policies and procedures
VALUES BASED COMPETENCIES:- Integrity Value: Model and Ensure Ethical Behavior
- Comply with Applicable Laws, Regulations and Policies
- Demonstrate Integrity
- Require Integrity and Ethical Behavior from Others
- Compassion Value: Deliver Value to Customers
- Maximize Customer Growth and Retention
- Optimize the Customer Experience
- Relationships Value: Lead and Develop People
- Bring in the Right Talent
- Develop People
- Drive Employee Engagement
- Foster Teamwork and Collaboration
- Learn and Develop Self
- Leverage Diversity and Inclusion
- Relationships Value: Communicate Effectively
- Communicate with Impact
- Influence and Negotiate
- Listen Actively
- Present Effectively
- Innovation Value: Lead Change and Innovation
- Demonstrate Emotional Resilience
- Implement Innovative Solutions
- Manage Change
- Performance Value: Drive Sound, Disciplined Decisions
- Apply Financial Knowledge
- Make Decisions to Drive Action
- Performance Value: Drive High-Quality Execution
- Communicate Clear Direction
- Drive Operational Excellence
- Manage Execution
*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 salary for this role will range from $60,200 - $107,400 annually 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.
