Call Center Nurse - Indianapolis, IN or Phoenix, AZ

• Customer Service:
  • Develop and maintain excellent performance and quality service for the Care Management team
  • Maintain a focus on the customer service through policy and program decisions and consider impact of these activities on the members
  • Facilitate interdepartmental communication as needed for integration purposes.
  • Facilitate problem resolution with members as needed.
• Clinical Application
  • Conduct initial assessments within designated timeframes on patients identified as having complex case management needs (assessment areas include clinical, behavioral, social, environmental, and financial)
  • Assess the patient's current medical and social circumstances.
  • Engage patient, family, and caregivers to assure that a well-coordinated treatment plan is established.
  • Utilize holistic approaches to the assessment process and integrates patient's life and motivational goals into the plan of care.
  • Prioritize care needs, set goals and develop an initial plan of care that also addresses gaps and/or barriers to care and uses evidence-based practice as the foundation.
• Quality Improvement
  • Documents per policy requirements.
  • Achieves productivity goals.
  • Complies with local, state, and federal laws and regulations.
  • Complete all Ethics and Integrity education programs.
  • Use company resources appropriately (e.g., technology, supplies).

AmeriChoice is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at AmeriChoice.

We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.

This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.

You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.

• High School Diploma or GED is required.
• Current and unrestricted license RN in the State of residence is required.
• 3 - 5 years clinical experience is required.
• Basic MS/Office (Word, Excel & Outlook) is required.
• Experience in behavioral health and complex, community case management is desired.
• Training, certification, and education in case management is desired.
• At least one year case management experience is preferred.
• Experience with state/government/CMS preferred.
• Bilingual (English / Spanish / Russian / Chinese (Cantonese & Mandarin) a plus.
• Experience working with state and government programs.
• Certification in case management is preferred.
• Knowledge of Medicaid and/or Medicare regulations is preferred.
• 2 years of Case Management or equivalent experience is strongly desired.