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 patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)
Positions in this function are responsible for supporting prevention interventions, coordination, data collection, and measurement of EPSDT services. This position is responsible for ongoing improvement activities associated with EPSDT eligible members, and reports to the Quality Management Leader. In addition, the EPSDT Coordinator reviews, identifies, and works with management to resolve any problematic EPSDT issues.
You'll enjoy the flexibility to telecommute from anywhere within Hawaii as you take on some tough challenges.
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Primary Responsibilities:
- Design and manage specific Quality Improvement (QI) interventions related to ensuring member receipt of EPSDT services and the creation of health improvement strategies under the direction of the QM Leader or manager
- Assist with monitoring of EPSDT data entry efforts and support monitoring and execution of follow-up, coordination of care and referral activities based upon EPSDT data obtained from EPSDT forms
- Support health plan coordination actions associated with State of Hawaii Department of Health Early Intervention Section (EIS) efforts to offer support and services for children with developmental delays or disabilities
- Meet with medical providers to discuss EPSDT, EIS or VFC activities, requirements or performance
- In-person visits with member and or personal representative to review and address concerns and issues (including compliance issues)
- Training to providers, community organizations and other identified groups to improve understanding of our EPSDT program, changes to the program and provision of information regarding community resources
- Develop provider and member education and training materials related to health promotion
- Early Intervention Section (EIS) efforts to offer support and services for children with developmental delays or disabilities
- Support and monitor health plan responsibilities associated with the Vaccines for Children (VFC) program
- Conduct an annual evaluation of the processes and outcomes for EPSDT program and continuous quality improvement activities
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:
- Hawaii Licensed Nurse or Physician's Assistant or Master's degree in health services, public health, health care administration or other related field and / or a Certified Professional in Health Care Quality (CPHQ)
- 2+ years of healthcare experience or other relevant experience
- Direct interaction working with providers
- Experience presenting to others
- Proficient with in a Windows environment, utilizing Outlook and advanced skills with Microsoft Excel and PowerPoint
- Ability to create spreadsheets and charts in Excel
- Comfort with reading and writing reports and analyzing data
- Access to reliable transportation that will enable you to travel to client and / or patient sites, physician offices or quality events within a designated area
Preferred Qualifications:
- Experience working with quality improvement activities
- Experience with wellness quality metrics related to childhood health screenings
- Experience working for a Medicaid and / or Medicare health care regulator or insurance organization
- Experience working with the pediatric population
- Experience with EPSDT
- Experience working within a managed care environment
- Ability to lead projects and collaborate with internal and external partners
- Experience working with providers and members to increase compliance with screenings
- Strong written and verbal communication skills
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: RN, BSN, EPSDT, Early And Periodic Screening, Diagnostic, And Treatment, Care Coordinator, Case Manager, Pediatric Nursing, Pediatrics, Pediatric, Medicaid, Medicare, Registered Nurse, Social Worker, Social Work, Telecommute, Telecommuting, Telecommuter, Work From Home, Remote, Honolulu, Maui, Kauai, Hawaii, HI