Riverside, California
Corpus Christi, Texas
Posted: 15-Oct-24
Location: Las Vegas, Nevada
Salary: Open
Categories:
Internal Number: 143480224
$10,000 Sign On Bonus for External Candidates
Optum NV is seeking a Senior RN Complex Case Manager to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.
As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone.
At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.
The Senior Case Manager will identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for members.
Primary Responsibilities:
- Applies motivational interviewing in identifying impact on member engagement and setting goals
- Member education, medication reconciliation and benefit management
- Ensures follow through with the Care Navigation Team; timely appointments and referrals to programs, health plan and community
- Facilitate patient/family and provider communications as indicated and advocate for patient/family with healthcare team as needed
- Ensures coordinated services delivered and available programs are accessed
- Communicate with stakeholders, appropriate health care related information to ensure timely coordination care and services for members currently receiving inpatient care
- Utilizes approved clinical criteria to asses and determine appropriate level of care for members currently receiving inpatient care
- Identified point of contact for managing transitions of care
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:
- Current, unrestricted NV RN license
- 3+ years of direct patient care nursing with a focus on discharge planning or case management
- Proven knowledge of UM and plan benefit designs
- Proven knowledge of Utilization review and MCG
- Competent with MS Office and other practice management systems or possess the ability to continue to learn new things
- Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
Preferred Qualifications:
- CCM certification
- Solid clinical knowledge and capacity for continued learning
- Proficient in critical thinking skills of RN Case manager
- Proven ability to organize and prioritize tasks for self and patients
- Proven solid verbal and written communication skills
- Ability to perform case management activities
Nevada Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
