$10,000 Sign On Bonus for External Candidates

 

Optum NV is seeking a Senior RN Case Manager - Complex Case 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.

 

The Senior Case Manager will identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for members. 

 

Primary Responsibilities:

Applies motivational interviewing in identifying impact on member engagement and setting goalsMember education, medication reconciliation and benefit managementEnsures follow through with the Care Navigation Team; timely appointments and referrals to programs, health plan and communityFacilitate patient/family and provider communications as indicated and advocate for patient/family with healthcare team as neededEnsures coordinated services delivered and available programs are accessedCommunicate with stakeholders, appropriate health care related information to ensure timely coordination care and services for members currently receiving inpatient careUtilizes approved clinical criteria to asses and determine appropriate level of care for members currently receiving inpatient careIdentified point of contact for managing transitions of care

 

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

Current, unrestricted NV RN license3+ years of direct patient care nursing with a focus on discharge planning or case managementCompetent with MS Office and other practice management systems or possess the ability to continue to learn new thingsAccess to reliable transportation that will enable you to travel to client and/or patient sites within a designated areaProven ability of time management skillsLiable transportation with valid driver's license and car insurance

 

Preferred Qualifications:

CCM certificationBSNSolid clinical knowledge and capacity for continued learningProficient in critical thinking skills of RN Case managerProven ability to organize and prioritize tasks for self and patientsProven solid verbal and written communication skillsProven ability to perform case management activities

 

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

$10,000 Sign On Bonus for External Candidates

 

Optum NV is seeking a Senior RN Case Manager - Complex Case 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.

 

The Senior Case Manager will identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for members. 

 

Primary Responsibilities:

Applies motivational interviewing in identifying impact on member engagement and setting goalsMember education, medication reconciliation and benefit managementEnsures follow through with the Care Navigation Team; timely appointments and referrals to programs, health plan and communityFacilitate patient/family and provider communications as indicated and advocate for patient/family with healthcare team as neededEnsures coordinated services delivered and available programs are accessedCommunicate with stakeholders, appropriate health care related information to ensure timely coordination care and services for members currently receiving inpatient careUtilizes approved clinical criteria to asses and determine appropriate level of care for members currently receiving inpatient careIdentified point of contact for managing transitions of care

 

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

Current, unrestricted NV RN license3+ years of direct patient care nursing with a focus on discharge planning or case managementCompetent with MS Office and other practice management systems or possess the ability to continue to learn new thingsAccess to reliable transportation that will enable you to travel to client and/or patient sites within a designated areaProven ability of time management skillsLiable transportation with valid driver's license and car insurance

 

Preferred Qualifications:

CCM certificationBSNSolid clinical knowledge and capacity for continued learningProficient in critical thinking skills of RN Case managerProven ability to organize and prioritize tasks for self and patientsProven solid verbal and written communication skillsProven ability to perform case management activities

 

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

$10,000 Sign On Bonus for External Candidates

 

Optum NV is seeking a Senior RN Case Manager - Complex Case 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.

 

The Senior Case Manager will identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for members. 

 

Primary Responsibilities:

Applies motivational interviewing in identifying impact on member engagement and setting goalsMember education, medication reconciliation and benefit managementEnsures follow through with the Care Navigation Team; timely appointments and referrals to programs, health plan and communityFacilitate patient/family and provider communications as indicated and advocate for patient/family with healthcare team as neededEnsures coordinated services delivered and available programs are accessedCommunicate with stakeholders, appropriate health care related information to ensure timely coordination care and services for members currently receiving inpatient careUtilizes approved clinical criteria to asses and determine appropriate level of care for members currently receiving inpatient careIdentified point of contact for managing transitions of care

 

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

Current, unrestricted NV RN license3+ years of direct patient care nursing with a focus on discharge planning or case managementCompetent with MS Office and other practice management systems or possess the ability to continue to learn new thingsAccess to reliable transportation that will enable you to travel to client and/or patient sites within a designated areaProven ability of time management skillsLiable transportation with valid driver's license and car insurance

 

Preferred Qualifications:

CCM certificationBSNSolid clinical knowledge and capacity for continued learningProficient in critical thinking skills of RN Case managerProven ability to organize and prioritize tasks for self and patientsProven solid verbal and written communication skillsProven ability to perform case management activities

 

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

$10,000 Sign On Bonus for External Candidates

 

Optum NV is seeking a Senior RN Case Manager - Complex Case 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.

 

The Senior Case Manager will identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for members. 

 

Primary Responsibilities:

Applies motivational interviewing in identifying impact on member engagement and setting goalsMember education, medication reconciliation and benefit managementEnsures follow through with the Care Navigation Team; timely appointments and referrals to programs, health plan and communityFacilitate patient/family and provider communications as indicated and advocate for patient/family with healthcare team as neededEnsures coordinated services delivered and available programs are accessedCommunicate with stakeholders, appropriate health care related information to ensure timely coordination care and services for members currently receiving inpatient careUtilizes approved clinical criteria to asses and determine appropriate level of care for members currently receiving inpatient careIdentified point of contact for managing transitions of care

 

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

Current, unrestricted NV RN license3+ years of direct patient care nursing with a focus on discharge planning or case managementCompetent with MS Office and other practice management systems or possess the ability to continue to learn new thingsAccess to reliable transportation that will enable you to travel to client and/or patient sites within a designated areaProven ability of time management skillsLiable transportation with valid driver's license and car insurance

 

Preferred Qualifications:

CCM certificationBSNSolid clinical knowledge and capacity for continued learningProficient in critical thinking skills of RN Case managerProven ability to organize and prioritize tasks for self and patientsProven solid verbal and written communication skillsProven ability to perform case management activities

 

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

$10,000 Sign On Bonus for External Candidates

 

Optum NV is seeking a Senior RN Case Manager - Complex Case 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.

 

The Senior Case Manager will identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for members. 

 

Primary Responsibilities:

Applies motivational interviewing in identifying impact on member engagement and setting goalsMember education, medication reconciliation and benefit managementEnsures follow through with the Care Navigation Team; timely appointments and referrals to programs, health plan and communityFacilitate patient/family and provider communications as indicated and advocate for patient/family with healthcare team as neededEnsures coordinated services delivered and available programs are accessedCommunicate with stakeholders, appropriate health care related information to ensure timely coordination care and services for members currently receiving inpatient careUtilizes approved clinical criteria to asses and determine appropriate level of care for members currently receiving inpatient careIdentified point of contact for managing transitions of care

 

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

Current, unrestricted NV RN license3+ years of direct patient care nursing with a focus on discharge planning or case managementCompetent with MS Office and other practice management systems or possess the ability to continue to learn new thingsAccess to reliable transportation that will enable you to travel to client and/or patient sites within a designated areaProven ability of time management skillsLiable transportation with valid driver's license and car insurance

 

Preferred Qualifications:

CCM certificationBSNSolid clinical knowledge and capacity for continued learningProficient in critical thinking skills of RN Case managerProven ability to organize and prioritize tasks for self and patientsProven solid verbal and written communication skillsProven ability to perform case management activities

 

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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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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$10,000 Sign-on Bonus  for External Candidates 

Full benefits within 30 days including annual bonus potential, annual merit reviews, generous PTO, paid holidays, 401K, tuition reimbursement and many more!

 

Optum NY, is seeking a Registered Nurse Manager Gastroenterology to join our team in Lake Success, NY. 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.

 

The Nurse Manager will be primarily responsible for overseeing the operational efficiency and quality of GI services, including direct supervision of Registered Nurses and indirect supervision and training of clinical staff (RN, LPN, & Endotechs). The manager will lead efforts to improve quality outcomes and clinic operations in a way that contributes to an enhanced experience for staff and patients; these quality improvements include (but are not limited to) Practice, Health & Safety Assessments, and accreditation surveys. Collaborative responsibilities include building and maintaining safe policies and patient protocol to ensure efficient operations of endoscopy services.

 

Position details:

Locations: Syosset, Lake Success, Massapequa, and Hewlett  The successful candidate can be located out of our Lake Sucess, Syosset or Hewlett locations!Specialty: Gastroenterology endoscopy procedural suite

 

Primary responsibilities:

Coordinates staff competency plan in collaboration with nursing education. Identifies and meets learning needs to maintain competency and respond to new clinical and management expectationsSupervises and directs all Registered Nurses employed in the endoscopy unitsAnalyzes quality data and information to identify areas for improving services and patient outcomesPrepares RN schedulesPlans for unit staffing needs on a long term and short-term basis, adjusts these appropriately to maintain safe, efficient care in an effective mannerActs as a resource to staff for regulatory and policy mattersEnsure strict adherence to Optum Practice, Health & Safety and third-party accreditor (TJC/AAAASF) policies, procedures, and standardsResponsible for ongoing accreditation of the GI endoscopy practices; including all quality  improvement, risk management, infection control, facility, and fire safetyOversees and participates on Performance Improvement Committee to facilitate improvement of nursing care and achievement of mission of the facilityRecognizes legal and policy limits of individual practiceCompletes annual evaluations of assigned staff

 

Optum NY/NJ was formed in 2022 by bringing together Riverside Medical Group, CareMount Medical, Crystal Run Healthcare and ProHealth Care. The regional alignment combines resources and services across the care continuum - from preventative medicine to diagnostics to treatment and beyond across New York, New Jersey, and Southern Connecticut. As a Patient Centered Medical Home, Optum NY/NJ can provide patient-focused medical care to the entire family. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Together, we're making health care work better for everyone.  

 

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:

BSNNursing Leadership experience BLS/ACLS certification - Required within the first 6 months of employmentDriver's License and access to reliable transportation

 

Preferred Qualifications: 

PACU/OR and/or ambulatory care nursing experienceKnowledge of and experienced with accreditation preferred (examples include but are not limited to Joint Commission accreditation, AAAHC accreditation, Quad A accreditation) 

 

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 $91,700 to $163,700 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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$10,000 Sign-on Bonus  for External Candidates 

Full benefits within 30 days including annual bonus potential, annual merit reviews, generous PTO, paid holidays, 401K, tuition reimbursement and many more!

 

Optum NY, is seeking a Registered Nurse Manager Gastroenterology to join our team in Lake Success, NY. 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.

 

The Nurse Manager will be primarily responsible for overseeing the operational efficiency and quality of GI services, including direct supervision of Registered Nurses and indirect supervision and training of clinical staff (RN, LPN, & Endotechs). The manager will lead efforts to improve quality outcomes and clinic operations in a way that contributes to an enhanced experience for staff and patients; these quality improvements include (but are not limited to) Practice, Health & Safety Assessments, and accreditation surveys. Collaborative responsibilities include building and maintaining safe policies and patient protocol to ensure efficient operations of endoscopy services.

 

Position details:

Locations: Syosset, Lake Success, Massapequa, and Hewlett  The successful candidate can be located out of our Lake Sucess, Syosset or Hewlett locations!Specialty: Gastroenterology endoscopy procedural suite

 

Primary responsibilities:

Coordinates staff competency plan in collaboration with nursing education. Identifies and meets learning needs to maintain competency and respond to new clinical and management expectationsSupervises and directs all Registered Nurses employed in the endoscopy unitsAnalyzes quality data and information to identify areas for improving services and patient outcomesPrepares RN schedulesPlans for unit staffing needs on a long term and short-term basis, adjusts these appropriately to maintain safe, efficient care in an effective mannerActs as a resource to staff for regulatory and policy mattersEnsure strict adherence to Optum Practice, Health & Safety and third-party accreditor (TJC/AAAASF) policies, procedures, and standardsResponsible for ongoing accreditation of the GI endoscopy practices; including all quality  improvement, risk management, infection control, facility, and fire safetyOversees and participates on Performance Improvement Committee to facilitate improvement of nursing care and achievement of mission of the facilityRecognizes legal and policy limits of individual practiceCompletes annual evaluations of assigned staff

 

Optum NY/NJ was formed in 2022 by bringing together Riverside Medical Group, CareMount Medical, Crystal Run Healthcare and ProHealth Care. The regional alignment combines resources and services across the care continuum - from preventative medicine to diagnostics to treatment and beyond across New York, New Jersey, and Southern Connecticut. As a Patient Centered Medical Home, Optum NY/NJ can provide patient-focused medical care to the entire family. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Together, we're making health care work better for everyone.  

 

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:

BSNNursing Leadership experience BLS/ACLS certification - Required within the first 6 months of employmentDriver's License and access to reliable transportation

 

Preferred Qualifications: 

PACU/OR and/or ambulatory care nursing experienceKnowledge of and experienced with accreditation preferred (examples include but are not limited to Joint Commission accreditation, AAAHC accreditation, Quad A accreditation) 

 

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 $91,700 to $163,700 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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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 to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

We are currently offering a $10,000 sign on bonus for external candidates!

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.

Daily operational responsibilities include utilization management, discharge planning, referral facilitation and/or collaboration with hospital- based case managers/physicians to move patients to appropriate level of care.  Provide Care interdisciplinary team communication about the hospital stays. This is an on-sight hospital- based function requiring the Case Manager RN to travel to 1-2 hospitals daily, work in collaboration with the hospitalist to improve outcomes with Observation stay, long discharge plans and prevention of readmission.

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) performs patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care.

Primary Responsibilities:

Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, lease restrictive level of careUtilize both company and community-based resources to establish a safe and effective case management plan for hospitalized membersCollaborate with patient, family and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge planCommunicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized membersAdvocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care teamUtilize approved clinical criteria to assess and determine appropriate level of care for hospitalized membersUnderstand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health planUnderstand role and how it affects utilization management benchmarks and quality outcomesCoordinate hand-off of care to primary care provider

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 and/or equivalentActive unrestricted Nevada RN licenseAbility to obtain CCM certification within two years of employment2+ years of varied clinical experience in a hospital or clinical setting with an emphasis on case managementExperience in a managed care organizationKnowledge of utilization management in a managed care environmentIndependent case management knowledge and skills to formulate plans of care without direct supervisionUnderstanding of spectrum of alternative delivery systemsAbility to use computer-based programs and applicationsDemonstrated initiative toward problem solving without direct supervisionProven solid organizational, written, oral computer skillsProven excellent problem-solving skillsProven ability to negotiate with professionals, patients, and caregiversCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care. Formulate plans that incorporate the health plan benefits, community services and patient self-directionValid Nevada driver's license and maintain personal auto insurance coverage

Preferred Qualifications:

Bachelor's degreeKnowledge of Interqual or Milliman guidelines Recent Emergency Room hospital care or hospital discharge planning

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation settingDriving up to one hour per day

Competencies for High Performers:   

Participation in departmental projects assigned by Director or ManagerCertification in Case Management (CCM) or equivalent Professional Certification (ACM)Metric measures of success: Observation rate discharge, Rate of engagement with patients high risk patients, improved readmission rate of high risk patients and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note

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 hourly pay for this role will range from $35 to $63 per hour 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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