Come join us for our upcoming virtual hiring event!

Event Date & Time: Tuesday July 14th at 12:00pm EST   Register here today: Florida Care Managers (Miami) & Care Review Clinicians Virtual Hiring Event

Event Date & Time: Thursday, July 23rd at 12:00pm EST Register here today: Florida Care Managers (Miami) & Care Review Clinicians Virtual Hiring Event

Event Date & Time: Thursday, July 30th at 12:00pm EST Register here today: Florida Care Manager Virtual Hiring Event – Molina HealthcareJOB DESCRIPTION Job Summary

Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. 

 

Essential Job Duties

• Completes comprehensive behavioral health assessments of members per regulated timelines and determines who may qualify for care coordination/case management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. 
• Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate healthcare professionals and member support network to address member needs and goals. 
• Conducts telephonic, face-to-face or home visits as required. 
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. 
• Maintains ongoing member caseload for regular outreach and management. 
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. 
• Facilitates interdisciplinary care team meetings and informal ICT collaboration. 
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. 
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns. 
• May provide consultation, resources and recommendations to peers as needed. 
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

 

Required Qualifications

• At least 2 years health care experience, preferably in behavioral health, or equivalent combination of relevant education and experience. 
• Licensed behavioral health clinician to include: Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT, Doctor of Psychology (PhD or PsyD) or equivalency based on state contract, regulation, or state board licensing mandate. If licensed, license must be active and unrestricted in state of practice. 
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. 
• Experience with working with persons with severe and persistent mental health concerns and serious emotional disturbances, to include substance use disorder and foster care. 
• Knowledge and experience related to whole person care principles, chronic health conditions, and discharge planning coordination. 
• Data entry skills and previous experience utilizing a clinical platform. 
• Excellent verbal and written communication skills. 
• Microsoft Office suite/applicable software program(s) proficiency. 

 

Preferred Qualifications

• Certified Case Manager (CCM). 
• Experience in behavioral health care management. 
• Field-based care management or home health experience.

 

#PJHS

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $26 - $42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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Come join us for our upcoming virtual hiring event! Event Date Read Less

About the Role & Team

At Disney Consumer Products, we inspire imagination around the world and are committed to creating happiness for families and fans by bringing captivating, inspiring, and inclusive products into their daily lives. From toys to t-shirts, console games, books, and more, our team brings our beloved brands and franchises into the lives of families through products and experiences that can be found worldwide, such as the Disney Store e-commerce platform, Disney Parks, local and international retailers, and Disney Store locations around the world!

The Disney Store Planning organization is responsible for developing a strategic financial plan to drive growth and profitability and deliver on the Guest experience. The team is the foundation of the DisneyStore.com Channel and works in partnership with Merchandising and Sourcing to deliver a range of items relevant to Disney Stores (e-commerce and brick-and-mortar).

You and your teams will drive a quarterly/annual financial strategy for an assortment across multiple categories, based on detailed knowledge of business insights and analytics, marketplace trends, and guest mix across channels. You will evaluate the assortment and react to in-season performance, trends, and takeaways to inform & adjust current and future seasons’ financial and inventory positioning. You will demonstrate a comprehensive understanding of all key financial performance indicators to build recommendations and influence the broader organization's execution.

The Senior Manager, Merchandise Planning, will report to the Director - Planning & Allocation and lead a team of 2 direct and 3 second-level reports.

This is a full-time role.

What You Will Do:

Lead the team that creates Category Plans, including weekly, monthly, and annual forecasts

Drive the business with full accountability for revenue and cost of goods for an area of responsibility

Own the pre-season & in-season planning, including forecasting and inventory open-to-buy management to drive growth and profitability

Analyze data, identify trends, and make data-driven decisions that provide actionable insights

Lead the development of monthly/annual cause-of-change models

Translate business performance drivers and metrics into informative analysis and recommendations, influencing organizational decisions

Identify pricing and liquidation opportunities for your division to manage inventory liability

Lead cross-functional merchandise meetings, provide input on product performance, assortment strategies, and inventory positioning

Mentor & develop team members’ skills to continually build bench strength and broaden career path opportunities

Required Qualifications & Skills:

6+ years of experience in merchandise planning, financial analysis, and/or strategy development

Leadership experience guiding and motivating hard-working teams with an excellent track record of achievement, advancement, and performance

Use financial forecasting, analytical, and communication skills to turn business performance data into useful insights and recommendations for senior leaders

Proven ability to shape business decisions, influence partners, and build relationships across the company

Apply storytelling techniques to financial data and present it to leaders at various levels

Ability to meet timelines, handle multiple priorities, and perform job responsibilities accurately while working in a fast-paced and vibrant environment

Familiarity with retail planning software or systems, MS Office, Excel, and an understanding of Business Intelligence tools

Preferred Qualifications & Skills:

Knowledge of retail planning software or systems such as Oracle MFP (Merchandise Financial Planning)

Understanding of Business Intelligence tools, including MicroStrategy

Proficiency in interpreting Tableau reports and leveraging the insights to enhance business performance

Self-starter with natural curiosity and the ability to deal with ambiguity

Ability to work within a sophisticated matrix organization and find creative solutions

Required Education:

Bachelor’s Degree and/or 6+ years of related experience

Preferred Education:

Bachelor’s Degree in Business, Finance, Mathematics, or other related fields

Additional Information: 

Disney offers a rewards package to help you live your best life. This includes health and savings benefits, educational opportunities, and special extras that only Disney can provide. Learn more about our benefits and perks at https://jobs.disneycareers.com/benefits. 

#DCPJobs

#DXMedia

The hiring range for this position in Glendale, CA is $139,200 to $186,600 per year. The base pay actually offered will take into account internal equity and also may vary depending on the candidate’s geographic region, job-related knowledge, skills, and experience among other factors. A bonus and/or long-term incentive units may be provided as part of the compensation package, in addition to the full range of medical, financial, and/or other benefits, dependent on the level and position offered. Read Less

Engineering Services Manager- Attractions Maintenance -3rd Shift will lead a maintenance team performing corrective and preventative maintenance on one of our world-renowned attractions and assets. You will oversee both mechanical and electrical trades, and you will need knowledge of both disciplines to lead up to 20-25 craft workers, but more importantly, you must know how to instill a can-do mindset in your team.

You must be willing to work evenings, holidays, weekends, and 3rd shift (11PM- 8AM) and working extended hours to complete time-sensitive tasks.

This is a 100% onsite position supporting the Disneyland Resort in Anaheim, CA.

You will report to Senior Manager-Engineering Services.

Responsibilities/You Will:

Provide leadership to attraction engineering services response teams; establish work schedules, shift assignments, and work prioritization.

Ensure customer service and communication to operations teams and other partners, providing accurate information, with status updates.

Complete projects that achieve client's goals and provide creative solutions to maximize value while finding delivery efficiencies for us.

Promote sound troubleshooting processes of multiple ride systems (including ride mechanical, ride control, show systems, building maintenance, and electrical systems), and use available resources to find a solution.

Ensure compliance with corporate, governmental, and regulatory agency policies and regulations, maintain appropriate records, and generate required reports.

Ensure Cast Members are trained in, and comply with, all applicable laws, regulations, and policies.

Be active in the field in an attractions environment.

Work from ladders, elevated platforms, and confined spaces at various times; work outdoors in various weather conditions.

Work evenings, holidays, weekends, and varying shifts including 3rd shift and working extended hours to complete time-sensitive tasks.

Basic Qualifications/You Will Have:

Experience establishing a vision for your team that fosters innovation, along with continuous improvement.

Experience successful team building.

Experience understanding and conveying written and verbal data and analysis to partners at all levels.

Understanding of diagnostic and evaluation skills with the ability to remove obstacles.

Understanding of how to consolidate multiple sources of information/analyses into a cohesive story and recommendation.

Well-developed tactics to balance time.

Demonstrated experience leading a team.

Experience in process control & mechanical systems.

3+ years of experience with Computerized Maintenance management system.

Proficiency in standard office software programs and mobile electronic devices.

Preferred Qualifications:

Experience with budget and scheduling management skills.

Demonstrated proficiency with MAXIMO.

Experience working in a Maintenance / Technical environment.

Background in maintenance management.

Required Education:

Bachelor's degree or equivalent and relevant technical experience.

Preferred Education:

Engineering degree.

Additional Information

Benefits and Perks: Disney offers a rewards package to help you live your best life. This includes health and savings benefits, educational opportunities, and special extras that only Disney can provide. Learn more about our benefits and perks at https://jobs.disneycareers.com/benefits.

#DXMedia

#DXFOS 

#LI-AH3

The hiring range for this position in Anaheim, CA is $115,300.00 to $140,900.00 per year. The base pay actually offered will take into account internal equity and also may vary depending on the candidate’s geographic region, job-related knowledge, skills, and experience among other factors. A bonus and/or long-term incentive units may be provided as part of the compensation package, in addition to the full range of medical, financial, and/or other benefits, dependent on the level and position offered. Read Less

Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

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Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

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Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

Read Less

Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

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Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

Read Less

Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

Read Less

Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

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Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.

Primary Responsibilities:

The Manager of Surgical Services provides leadership in the daily clinical operations of the Operating Room, Central Sterile Processing Department, Pre-Op and PACU departments, in accordance with established State rules and regulations, AAAHC and AORN standards for ambulatory surgical facilitiesDevelops and enforces compliance with ASC policies and proceduresThis position works closely with the providers, ASC Director, and ASC Leadership team

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:

BSN or 5+years of comparable experience in an ASCActive current TX LicenseBCLS - AHA Healthcare ProviderCNOR certification or ability to obtain within a year of hire5+ years of clinical experience in the OR3+ years of experience in managementComputer skills; working knowledge of Word, PowerPointDriver's License and access to reliable transportation

 

Preferred Qualifications:

MSNSpecialty Certification - PreoperativeAmbulatory Surgery experienceAAAHC Preparation experience

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Read Less

Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

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$7,500 Sign On Bonus for External Candidates

 

Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere.  As a team member of our Optum Care at Home team, together in an interdisciplinary care environment, we help patients navigate the health care system and connect them to key support services. This preventive care can help patients stay well at home.  This life-changing work adds a layer of support to improve access to care. We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together. 

 

Location: Field based position throughout Seattle, WA

Work Schedule: Monday through Friday 8:00 a.m. - 5:00 p.m. PST  Hours may vary based on business needs  

 

Primary Responsibilities:

Visit members in their homes to assess their current health statusIdentify gaps or barriers in treatment plansProvide patient education to assist with self-managementMake referrals to outside sourcesProvide a complete continuum of quality care through close communication with members via in-person in home or on-phone interactionSupport members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels

 

This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Strong computer and software navigation skills are critical. You should also be strongly patient-focused and adaptable to changes.

 

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 RN license in the state of WashingtonCertified in Basic Life Support, or ability to obtain by start date1+ years of clinical experienceExperience in home care/home visitsReside in or near Seattle, WADriver's license and access to reliable transportation

 

Preferred Qualifications:

BSNCertified Case Manager (CCM)Case management experienceExperience in discharge planningExperience in utilization review, concurrent review or risk management

Experience in a telephonic role

 

Experience working with MS Word, Excel and OutlookBackground in managed careBilingual in English/Spanish

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

Read Less

Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

Read Less

Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

Read Less

Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

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Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

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Optum NV is seeking a Case Manager RN - Cardiology 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. 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.

 

Position in this function is responsible for the care management and coordination of all high risk high need patients assigned to a specific site, including both in and out patient clinical care.  Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients and families and providers.  Maintains records and data analysis related to high risk cases to report outcomes and ROI.  Works collaboratively with all internal and external partners to ensure better clinical outcomes.  

 

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics/programs that are of interest.  The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically.  

 

Primary Responsibilities:

Apply case management standards of practice to focus on effective care of high risk high need patients at a specific siteServe as a patient advocate and resource and provide critical information and recommendations to the rest of the care teamParticipates in assessment activities to develop individualized  plans of care in coordination with patient, family and providersFollows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care deliveryMaintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomesWorks collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of careAssist clinicians in implementing best practices for chronic care and disease managementFollow standard protocols, processes and policies to include but not limited to the following:  Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designeeCare management and coordinating care for our high risk Cardiology and CHF patientsKnowledge of Milliman criteria and utilizing these criteria to manage CHF patientsAssist Clinicians in implementing best practices for chronic care and disease managementParticipates in assessment activities to develop individualized plans of care with patients, family and ProvidersProvide patient education on disease processes to help promote self-management and complianceResponsible for maintaining an active caseload and provide interventions as needed within area of expertise and within their scope of practiceHeart Failure disease management (telephonic and/or in person) will focus on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients and helping patients with the implementation of the treatment planResponsible for ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; Assisting in reducing readmission ratesExercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistanceMake outbound telephone calls to patients to assess members' current health status.Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concernsResponsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's homeResponsible for telephonic nursing assessment of biometric alerts, mission information and intervention accordingly within their scope of practiceMaintains monthly statistics generated from current patient case load and telephonic patient case loadKnowledge of relevant computer systems and software applications (e.g., IDX; MS Word; MS Excel; Outlook; Touchworks) or ability to learn new programsCommunicates with customers in a manner that is clear, concise and understandable. Utilizes appropriate phone etiquette and effective listening skills when interacting with customers/familyMaintaining relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)Functioning as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resourcesAssisting Supervisor and/or Manager with department related projects by completing tasks correctly and efficientlyAdheres to Internal company/department-specific protocols, procedures, policies and workflowsMay perform other required duties and responsibilities as outlined by the company/department

 

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:

High School diploma or equivalentRegistered Nurse with active unrestricted license in the State of NevadaMust possess a valid Nevada driver's license and maintain personal auto insurance coverageBLS certification or obtain within 30 days of hire 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)Knowledge of UM and plan benefit designsDemonstrated ability to perform case management activitiesDemonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learningProven ability to demonstrate knowledge of and apply those to the job function and responsibilitiesProven to possess solid verbal and written communication skills including excellent phone etiquette and customer service skillsProven competent with MS Office, Excel and other practice management systems or possess the ability to continue to learn new programs

 

Preferred Qualifications:

Bachelor's degree in healthcare or related field preferred or working towards completion of Bachelor's degreeCCM certificationACLS certification or must be able to complete certification within 30 days of hireExperience in Cardiology, Case Management and CCM certification

 

Working Conditions:  Normal clinic environment.  Ability to have their own transportation to travel frequently within the Las Vegas Valley.  Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic. Moderate to heavy phone and computer usage.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

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