Shareholders and Investors

Universal American has been on the cutting edge of healthcare for over two decades, pioneering innovative collaborations between patients, doctors and our company that produce healthy outcomes for all.

We have an exciting opportunity for a Telephonic LVN Case Manager in our Houston office. The LVN Case Manager maximizes the components of the out-patient settings by utilizing care coordination tools, criteria and protocols to:

• Provide members with chronic and acute conditions, the support, education and assistance in the prevention and/or
  maintenance of their disease and/or health and wellness state;
• Increase member compliance with treatment plans;
• Engage community resources to support the members' optimal functioning and;
• Improve collaborative coordination of care to affect waste and inefficiency.

Responsibilities:

• Provide telephonic follow up with members for case management services once discharged from facility, or once member has been stratified at a level requiring case management follow up.
• Facilitate provider contact as needed to coordinate member's care needs. Inputs authorizations as needed for members under case management.
• Identify high risk members for disease or case management needs and works with member, physician and other Health care providers to establish a plan of care to meet the member's individual needs. This would result in a call to the identified member to explain the program, assess needs, educate member regarding the disease as appropriate.
• Instruct the member on how to access the program resources, suggest and/ or arrange follow-up including mailing of educational materials, contact with community resources, facilitate physician visits.
• Document all contacts in the Health Services clinical documentation system.
• Manage members in current disease management programs, completing and revising as necessary, the information in clinical documentation system.
• Comply with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable, and defined in the Universal American Corporate and department policies.
• And all other duties assigned by the manager and/or supervisor.

Required Skills:

• Professional verbal and written communication skills, with the ability to clearly articulate thoughts and ideas.
• Organizational skills with the ability to handle multiple tasks and/or projects at one time.
• Customer service skills with the ability to interact professionally and effectively with providers, third party payers, physicians, and staff from all departments within and outside the Company.
• Analytical and interpretation skills including departmental, utilization, financial and operations data.
• Decision-making skills with the ability to investigate and weigh alternatives and select the course of action that provides the greatest benefit to the organization.
• Creative thinking skills with the ability to ask the needed bigger-picture questions that lead to process and team improvements.
• Time management skills with the ability to prioritize and schedule daily activities for the most efficient use of time.
• Problem solving skills with the ability to look for root causes and implementable, workable solutions.
• Interpersonal skills with the ability to work in a fast-paced environment and participate as an independent contributor with little supervision or as an active team member depending on the situation and needs.
• Must have a track record of producing work that is highly accurate, demonstrates attention to detail, and reflects well on the organization.

Required Experience:

• LVN with current state licensure and at least 2 years' experience
• CMCN and/or related certification or eligible to take exam within two years of employment
• Two years' utilization management and/or case management experience within a hospital, home health setting or managed care company is preferred
• Working knowledge of CMS
• Personal computer experience should include working with Microsoft Word, Excel, PowerPoint and Outlook at the intermediate level at a minimum

Universal American Corp. is an Equal Opportunity / Affirmative Action Employer and does not discriminate because of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, military veteran status, or any other characteristic protected by law. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce.

For more information on Universal American, please visit our website at www.UniversalAmerican.com.