“When a door is closed to you, go under that door.”

Now in her 19th year at VNSNY, CHOICE MLTC Care Coordinator Marian Unterman spent her first two years at VNSNY as a per diem nurse in VNSNY Acute Care while studying for her Nurse Practitioner degree and certification. She then worked for VNSNY’s former Esprit medical practice for 13 years, treating her own panel of primary care patients, consulting on patients with complex medical needs and empowering her colleagues through education. Today, in her work for CHOICE MLTC, Marian travels from her Manhattan home to the VNSNY Brooklyn office or works remotely, dispensing telephone-based guidance, education, and support for the approximately 180 members under her care.

 “I see health as a human right, and I sometimes see myself as a human rights activist, advocating for the specific needs of each individual patient.” That’s the personal philosophy and approach that Marian applies to her work as a Care Coordinator for the VNSNY CHOICE MLTC health plan. She speaks by phone with anywhere from 10 to 20-plus CHOICE MLTC members or their caregivers each day, helping them navigate the ins-and-outs of their insurance, organizing their care based on their needs and goals, educating them about their VNSNY programs and community-based resources, collaborating in their care through changes in setting (for example, transitioning from a hospital or sub-acute facility), and determining the best route to take in order to keep them comfortable, healthy, and safe in their homes and prevent hospitalizations. 

“A patient’s unique situation can’t be fully assessed in an initial call,” Marian notes. “It changes and unfolds over time.” In the case of the letter linked to this profile, Marian spoke with the member’s daughter multiple times each week, sometimes several times per day, to guide the member’s care check on her status and adherence to the care plan, offer support and options, and provide the information needed to make appropriate decisions.She also provided hands-on care management when necessary. In one instance, she contacted an outside physician to ensure that the member received the appropriate level of attention. Another time, a change in the member’s health brought her to the ER. Hospital staff felt she should be admitted, but the family preferred that she remain at home and enter VNSNY Hospice.

“I was able to assure the hospital representatives that she could receive the care she needed at home,” Marian explains. “Within a few hours, with the collaboration of VNSNY Hospice, the necessary medical equipment was in her bedroom and our terrific hospice team was on the scene to enroll her the following morning.”

In addition to listening to CHOICE MLTC members and their caregivers, Marian also makes it a point to communicate with them calmly, clearly, and continually. She focuses on empowering members to make decisions by educating members on how to manage their health, and explaining their coverage and care options, fostering their trust so she can guide them through transitions, and advocating for them tirelessly whenever required.

“I feel that you need to use all of your knowledge and skills to find a way to help people in your care,” Marian explains. “When a door is closed to you, go under that door. When the conventional doesn’t work, within reason, try the unconventional.”

She adds, “I start each case with a commitment to complete it and guide the plan member through the whole process. VNSNY is a place where people truly care about our patients and members. We can make a difference in their lives by keeping them as healthy as they can be in the place where they are most comfortable. It’s what we do here.”