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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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

 

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

First Hill Surgery Center is a multi- specialty outpatient surgery center seeking a full-time OR Nurse Manager responsible for the operations, personnel, and financial management of the Operating Rooms. The role is accountable to support the Executive Director of First Hill Surgery Center, to ensure high quality, safe and appropriate nursing care, competency of clinical and non-clinical staff, and appropriate resource management related to patient care.

First Hill Surgery Center operates as joint venture between Polyclinic, dba Optum, and Swedish Health Services. Our AAAHC accredited, state of the art, 12 operating room, multi-specialty surgery center specializes in Orthopedics, Spine Surgery, Pain Management, Urology, General Surgery, Breast Surgery, Gynecology, Bariatrics, Ear, Nose and Throat, Podiatry, Colorectal Surgery, and Ophthalmology. First Hill Surgery Center is a leader in the outpatient surgery industry located near Swedish Hospital and Virginia Mason Hospitals in Seattle, WA.

Primary Responsibilities:

Maintains the Operating Room as assigned, in accordance with written policies and in compliance with various regulatory and accrediting agenciesEffective staffing management of labor/productivity as well as flexing teammates appropriatelyAbility to maintain a high level of collaboration and communication through team meetings and daily huddles via in-person, electronic and written formatsAssists with the development and monitoring of the standards of assigned areas pertaining to the Operating Room, and corresponding ancillary areasEfficient and effective patient care and quality improvementHelps in determining goals and effectively manages resources to achieve the goalsProvides immediate mentoring/coaching to teammates as neededMaintains a collegial relationship with physicians to ensure quality patient careManages Vendor coordination and ensures compliance of FHSC Policies

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

Required Qualifications:

BSN from an accredited school of nursingValid WA RN LicenseBLS and ACLS or obtain within 2 months of hireSolid competency as an RN circulator with preference given to those who have scrub experience

Preferred Qualifications:

CNOR, CNAMB, or CSSM2+ years management/leadership in the operating room

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 $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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

 

 

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.

Read Less

$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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For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

As the Palliative Care Manager, you provide expert palliative care support to patients and families while strengthening primary palliative care capabilities across clinical teams. You improve quality of life for patients with serious illness by leading advanced communication and goals-of-care discussions, supporting symptom management, coordinating care, and collaborating across interdisciplinary teams. You partner across care settings to ensure compassionate, patient-centered, and goal-concordant care throughout the disease trajectory.

Primary Responsibilities:

Conducts home dyad visitsConducts telephonic nursing follow upAssess patient and family understanding, values, and preferences to guide care decisionsDevelop, implement, and adjust individualized palliative care plans aligned with clinical status and patient goalsCoordinate care across settings (primary care, specialty care, inpatient, SNF, hospice, home health, community partners)Support advance care planning, including POLST, advance directives, and DPOA documentationDocument complex cases, care plans, and transitions clearly and in a timely mannerManage competing priorities independently while adhering to organizational policies and regulatory requirementsEducate and coach staff on serious illness communication, symptom management, and palliative care principlesPromote interdisciplinary collaboration and patient-centered care practicesParticipate in case reviews and team meetingsEngage in ongoing professional development in palliative care best practicesFoster a collaborative, respectful, and patient-centered work environmentMaintain strong relationships with patients, families, providers, and community partnersDemonstrate professionalism, adaptability, and emotional intelligenceSupport organizational mission, values, and continuous improvement initiatives
 

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, active RN licensure in the State of WashingtonCurrent BLS certification or ability to obtain certification within 30 days of employment hire date3+ years of experience in a physician's office, clinical, hospice or hospital settingValid driver's license within the state of workReliable transportation for daily travel to various locations as assigned

Preferred Qualifications:

BSNCertification or specialized training in palliative careExperience in palliative care, hospice, geriatrics, complex case management, or serious illness careExperience working with geriatric populationsExperience providing staff education, coaching, or clinical training

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 $91,500 - $137, 300 annually based on full-time employment. We comply with all minimum wage laws as applicable.
 

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

 

 
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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Job Summary 

Manage and oversee a high-volume 24/7 Command Center supporting approximately 73 properties. This role manages emergency dispatch, CCTV monitoring, alarm monitoring for access control systems, temperature alarms, elevators and other critical systems. Also, maintenance ticket coordination. Responsible for managing command center officers on each shift while ensuring rapid response, compliance, and operational excellence.

Key Responsibilities

• Oversee 24/7 command center operations responsible for 73 properties 

• Manage supervisor and officers across all shifts 

• Coordinate emergency dispatch and alarm response, as well as ensuring timely reporting from the command center officers. 

• Oversee the staff monitor CCTV, access control, and life-safety systems appropriately and timely response, and reporting. 

• Ensure staff are trained and compliant with all post order requirements. 

• Lead serious incident response and reporting 

• Maintain SOP compliance and client communication 

• Conduct training, audits, and performance management 

Requirements 

• 5+ years command center or security operations leadership 

• Experience managing multi-site monitoring operations 

• Strong knowledge of CCTV, access control, alarms 

• Experience in fast-paced dispatch environments 

• Ability to manage 24/7 teams and critical incidents 

• Strong communication, management, and reporting skills 

Employment Type: Full Time
Years Experience: 5 - 10 years
Salary: $90,000 Annual
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"A Day in the Life" video

Opportunities with Genoa Healthcare.  A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services - in-clinic pharmacies, medication management and more - are leading the way to a new level of care. 

Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group's family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start Caring. Connecting. Growing together.  

The Account Manager manages a portfolio of residential and healthcare partner accounts, including assisted living homes, group homes, center partners, outpatient clinics, substance abuse facilities, and other community-based settings. Serving as a primary liaison between Genoa Healthcare, pharmacy operations, and client partners, this role focuses on relationship management, proactive account support, and timely resolution of service, operational, and billing issues to maintain and grow the business.

The Account Manager works closely with pharmacy, billing, operational, and business development teams to support onboarding, retention, service continuity, growth metrics.  Responsibilities include maintaining a quarterly outreach cadence through site visits and remote follow-up, vaccination support, assisting with invoice and past-due account follow-up, and helping deliver a responsive, relationship-centered client experience.

If you are located in or within the state of NH, VT, and ME, you'll enjoy the flexibility to work telecommute * as you take on some tough challenges.

Primary Responsibilities: 

Client Relationship Management

Serve as the primary relationship owner for assigned residential and healthcare partner accounts, supporting retention, service continuity, and growthBuild strong relationships with facility staff, pharmacy teams, and key contacts through consistent communication and follow-throughMaintain a consistent quarterly outreach cadence through in-person or virtual visits, phone calls, text messages, or email based on account needs and preferencesAct as the point of escalation for service, operational, and billing concerns, working between facilities and pharmacies to reach timely, practical resolutions

Growth & Business Development

Identify opportunities to strengthen existing accounts through responsive service, improved coordination, and consistent relationship managementPartner closely with business development representatives and pharmacy teams to support smooth onboarding and successful integration of new accounts leading to future full ownership of those accountsProactively identify account risks, service gaps, and relationship concerns early so they can be addressed before they affect retention and growthMaintain an organized territory coverage plan that supports regular site visits, balanced travel scheduling, and timely follow-up across assigned markets

Account Oversight & Operational Support

Own performance across assigned accounts by supporting retention, service continuity, responsive account management, and growthMonitor account activity, service issues, billing needs, and follow-up requirements to help ensure timely support for each siteUse available account information, statements, and site-level details to guide outreach priorities and support problem-solving with internal teams

Cross-Functional Collaboration

Serve as a liaison between pharmacy operations, billing, business development, and client partners to align account needs and next stepsAssist and support the BDR in the coordination of onboarding activities for new accounts and support implementation tasks that help accounts transition smoothlyEnsure timely communication, documentation, and follow-up with internal stakeholders and external account contacts after visits, calls, and issue escalations

Client Engagement & Education

Educate account partners on available services, pharmacy processes, billing follow-up, and operational expectations to support effective collaborationCoordinate client-facing activities such as site visits, outreach, and immunization eventsShare observations from the field with internal teams and recommend practical solutions that reflect account needs, service trends, and operational realities

Performance Metrics (KPIs)

Success in this role will be measured through relationship strength, account retention, outreach consistency, growth,  and operational follow-through across assigned accounts, including:

Account Retention and Growth: Retention rate of assigned accounts and continuity of service support to enact growth of this accountQuarterly Outreach Completion: Percentage of assigned accounts receiving scheduled visits or other quarterly touchpointsIssue Resolution Effectiveness: Timeliness and quality of follow-up on service, operational, and billing concernsBilling Follow-Up: Completion of invoice, statement, hard hold, and past-due follow-up activities assignedOnboarding Support: Successful coordination and follow-through for new account transitionsAccount Responsiveness: Timely communication and documented follow-up after visits, calls, and escalationsClient Satisfaction: Feedback from facilities, pharmacies, and partners regarding service support and relationship managementScheduling Effectiveness: Ability to maintain organized travel plans, account coverage, and regular contact across assigned territoriesOperational Support: Consistent coordination of site needs, flu clinic support, and account-related tasks in partnership with internal teams

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:

4+ years' experience supporting pharmacy or healthcare operations4+ years' experience in pharmacy or healthcare account management, in a client-facing support role6+ months of experience building external client relationships and coordinating across internal teams to resolve issues and support account needsValid driver's license, reliable transportation, and ability to travel regularly up to 75% of the time to customer sites while managing a structured field schedule

Preferred Qualifications:

Experience supporting residential, behavioral health, outpatient, substance use disorder, or other community-based healthcare accountsLicensed Pharmacy TechnicianExperience with invoice support, billing follow-up, account onboarding, or related operational coordination activitiesExperience coordinating healthcare related eventsProficiency with MS Office

Soft Skills:

Strong history of working with multiple stakeholders in a fast paced healthcare environment, including the ability to multitask, problem-solve  and prioritizeStrong organizational skills, including territory planning, visit scheduling, and documentation of account follow-up

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

    

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 $29.00 to $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 

    

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

    

    

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

    

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

    

   

#RPO #RED

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At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

The Nursing Facility Care Manager is responsible for facilitating, promoting, and advocating for the enrollees' ongoing self-sufficiency and independence. This position is responsible for assessment and planning for an identified group of patients in Nursing Facilities. Additionally, the care coordinator is responsible for assessing the availability of natural supports such as the enrollee's representative or family members to ensure the ongoing mental and physical health of those natural supports.

The Nursing Facility Care Manager collaborates with the Interdisciplinary Team to coordinate the delivery of comprehensive, efficient, cost-effective patient care. The Nursing Facility Care Manager will be traveling into nursing facilities, Adult Day Health, and Adult Living Facilities (ALF) to conduct in-depth assessments and develop the plan of care.

The Nursing Facility Care Manager actively assists enrollees with care transitions in collaboration with the Interdisciplinary Team and the acute or skilled facility staff, and the enrollees and / or the enrollees' representatives. The Nursing Facility Care Manager act as liaison between the Health Plan, the Commonwealth, enrollees, and their families.  

The Nursing Facility Care Manager follows established professional standards of care, Commonwealth guidelines and policy and procedures.

This is a field-based position visiting Nursing Facilities based in Western VA Markets. For consideration, you must reside within a commutable distance of Washington County, Grayson County and Smyth County VA Markets Alleghany or Rockbridge Counties in VA.

If you reside within a commutable distance of Madison, Charlottesville, Waynesboro, Fluvanna, or Staunton, VA Markets, you will have the flexibility to work remotely* as you take on some tough challenges. 

Primary Responsibilities:

Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needsDevelop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelinesPartner and collaborate with internal care team, providers, and community resources/partners to implement care planProvide education and coaching to support member self-management of care needs and lifestyle changes to promote healthSupport proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admissionAdvocate for members and families as needed to ensure the members' needs and choices are fully represented and supported by the health care team

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 and unrestricted Licensed Practical Nurse in the state of Virginia OR Social Work or Human Services (or related field) with a 4-year degree3+ years of care coordination or behavioral health experience and/or work in a healthcare environment 1+ years of experience with MS Office, including Word, Excel, and Outlook  Experience working with members who have medical needs, the elderly, individuals with physical disabilities and / or those who may have communication barriers  Access to reliable transportation and valid US driver's license with the ability to travel within assigned territory to meet with members and providers

Preferred Qualifications:

CCM certificationExperience working with Medicaid / Medicare populationExperience working in team-based careLong term care / geriatric experienceBackground in Managed Care

Physical Requirements:

Ability to transition from office to field locations multiple times per dayAbility to navigate multiple locations/terrains to visit employees, members and/or providersAbility to transport equipment to and from field locations needed for visits (ex. laptop, stethoscope, etc.)Ability to remain stationary for long periods of time to complete computer or tablet work duties

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

        

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 $24 - $43 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

      

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

     

 

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

 

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

   

 

#RPO #RED

Read Less

Opportunities at Northern Light Health, in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind: Caring. Connecting. Growing together.  

The Care Manager RN - Per Diem provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients/caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Facilitates appropriate LOS, patient experience, and reimbursement for all patients. Develops and maintains collaborative relationships with all members of the healthcare team.  Through clinical care coordination drives efficient utilization of resources to reduce length of stay, improve patient flow and throughput, limits variation by applying innovative and evidence-based practice, and to reduce the risk of readmission.

Schedule: Flexible Schedule - Required to work 1 Saturday Quarterly

Location: 175 Foreriver Parkway, Portland, ME

Primary Responsibilities:

Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an educational resource to all Health System staff regarding utilization reviewAssumes roles in assessment physical, psychosocial, & economic needs for transition of care planning to a variety of levels of care, delegates to others as appropriate Documents, verifies, and validates specific data required to monitor and evaluate interventions and outcomesInterviews and collects patient specified data and chart review related to readmission and appropriately notifies care teamCommunicates telephonically and electronically with outpatient providers to enhance the continuum of careIntegrates performance improvement principles and customer service excellence principles into all aspects of job responsibilities, practice and governmental commercial payer guidelinesAdheres to the policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodiesAssume responsibility for Health System required continued education and owns professional growthPerforms tasks of a clinical nature within scope of assigned duties and clinical expertiseCommunicate effectively in both oral and written form, as appropriate for the needs of the audiencePerforms other duties as assigned or required

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

Required Qualifications:

Associate's Degree (or higher) in NursingCurrent, unrestricted RN license in the state of employment1+ years of experience in a hospital, acute care, or direct care settingIntermediate level of proficiency to navigate Windows based environment and the ability to typeAbility to work one Saturday, quarterly

Preferred Qualifications:

Bachelor's Degree in Nursing (BSN)Previous background in managed careCertified Case Manager (CCM)1+ years of Case management experienceExperience or exposure to discharge planning

 

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 $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 

    

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

   

    

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

   

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

    

 

#RPO #RED #RPOLinkedin

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Opportunities at Northern Light Health, in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind: Caring. Connecting. Growing together.  

The Care Manager RN - Per Diem provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients/caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Facilitates appropriate LOS, patient experience, and reimbursement for all patients. Develops and maintains collaborative relationships with all members of the healthcare team.  Through clinical care coordination drives efficient utilization of resources to reduce length of stay, improve patient flow and throughput, limits variation by applying innovative and evidence-based practice, and to reduce the risk of readmission.

Schedule: Flexible Schedule - Required to work 1 Saturday Quarterly

Location: 175 Foreriver Parkway, Portland, ME

Primary Responsibilities:

Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an educational resource to all Health System staff regarding utilization reviewAssumes roles in assessment physical, psychosocial, & economic needs for transition of care planning to a variety of levels of care, delegates to others as appropriate Documents, verifies, and validates specific data required to monitor and evaluate interventions and outcomesInterviews and collects patient specified data and chart review related to readmission and appropriately notifies care teamCommunicates telephonically and electronically with outpatient providers to enhance the continuum of careIntegrates performance improvement principles and customer service excellence principles into all aspects of job responsibilities, practice and governmental commercial payer guidelinesAdheres to the policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodiesAssume responsibility for Health System required continued education and owns professional growthPerforms tasks of a clinical nature within scope of assigned duties and clinical expertiseCommunicate effectively in both oral and written form, as appropriate for the needs of the audiencePerforms other duties as assigned or required

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

Required Qualifications:

Associate's Degree (or higher) in NursingCurrent, unrestricted RN license in the state of employment1+ years of experience in a hospital, acute care, or direct care settingIntermediate level of proficiency to navigate Windows based environment and the ability to typeAbility to work one Saturday, quarterly

Preferred Qualifications:

Bachelor's Degree in Nursing (BSN)Previous background in managed careCertified Case Manager (CCM)1+ years of Case management experienceExperience or exposure to discharge planning

 

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 $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 

    

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

   

    

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

   

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

    

 

#RPO #RED #RPOLinkedin

Read Less

Opportunities at Northern Light Health, in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind: Caring. Connecting. Growing together.  

The Care Manager RN - Per Diem provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients/caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Facilitates appropriate LOS, patient experience, and reimbursement for all patients. Develops and maintains collaborative relationships with all members of the healthcare team.  Through clinical care coordination drives efficient utilization of resources to reduce length of stay, improve patient flow and throughput, limits variation by applying innovative and evidence-based practice, and to reduce the risk of readmission.

Schedule: Flexible Schedule - Required to work 1 Saturday Quarterly

Location: 175 Foreriver Parkway, Portland, ME

Primary Responsibilities:

Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an educational resource to all Health System staff regarding utilization reviewAssumes roles in assessment physical, psychosocial, & economic needs for transition of care planning to a variety of levels of care, delegates to others as appropriate Documents, verifies, and validates specific data required to monitor and evaluate interventions and outcomesInterviews and collects patient specified data and chart review related to readmission and appropriately notifies care teamCommunicates telephonically and electronically with outpatient providers to enhance the continuum of careIntegrates performance improvement principles and customer service excellence principles into all aspects of job responsibilities, practice and governmental commercial payer guidelinesAdheres to the policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodiesAssume responsibility for Health System required continued education and owns professional growthPerforms tasks of a clinical nature within scope of assigned duties and clinical expertiseCommunicate effectively in both oral and written form, as appropriate for the needs of the audiencePerforms other duties as assigned or required

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

Required Qualifications:

Associate's Degree (or higher) in NursingCurrent, unrestricted RN license in the state of employment1+ years of experience in a hospital, acute care, or direct care settingIntermediate level of proficiency to navigate Windows based environment and the ability to typeAbility to work one Saturday, quarterly

Preferred Qualifications:

Bachelor's Degree in Nursing (BSN)Previous background in managed careCertified Case Manager (CCM)1+ years of Case management experienceExperience or exposure to discharge planning

 

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 $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 

    

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

   

    

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

   

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

    

 

#RPO #RED #RPOLinkedin

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"A Day in the Life" video

Opportunities with Genoa Healthcare.  A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services - in-clinic pharmacies, medication management and more - are leading the way to a new level of care. 

Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group's family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start Caring. Connecting. Growing together.  

The Account Manager manages a portfolio of residential and healthcare partner accounts, including assisted living homes, group homes, center partners, outpatient clinics, substance abuse facilities, and other community-based settings. Serving as a primary liaison between Genoa Healthcare, pharmacy operations, and client partners, this role focuses on relationship management, proactive account support, and timely resolution of service, operational, and billing issues to maintain and grow the business.

The Account Manager works closely with pharmacy, billing, operational, and business development teams to support onboarding, retention, service continuity, growth metrics.  Responsibilities include maintaining a quarterly outreach cadence through site visits and remote follow-up, vaccination support, assisting with invoice and past-due account follow-up, and helping deliver a responsive, relationship-centered client experience.

If you reside in OR, ID, you'll enjoy the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities: 

Client Relationship Management

Serve as the primary relationship owner for assigned residential and healthcare partner accounts, supporting retention, service continuity, and growthBuild strong relationships with facility staff, pharmacy teams, and key contacts through consistent communication and follow-throughMaintain a consistent quarterly outreach cadence through in-person or virtual visits, phone calls, text messages, or email based on account needs and preferencesAct as the point of escalation for service, operational, and billing concerns, working between facilities and pharmacies to reach timely, practical resolutions

Growth & Business Development

Identify opportunities to strengthen existing accounts through responsive service, improved coordination, and consistent relationship managementPartner closely with business development representatives and pharmacy teams to support smooth onboarding and successful integration of new accounts leading to future full ownership of those accountsProactively identify account risks, service gaps, and relationship concerns early so they can be addressed before they affect retention and growthMaintain an organized territory coverage plan that supports regular site visits, balanced travel scheduling, and timely follow-up across assigned markets

Account Oversight & Operational Support

Own performance across assigned accounts by supporting retention, service continuity, responsive account management, and growthMonitor account activity, service issues, billing needs, and follow-up requirements to help ensure timely support for each siteUse available account information, statements, and site-level details to guide outreach priorities and support problem-solving with internal teams

Cross-Functional Collaboration

Serve as a liaison between pharmacy operations, billing, business development, and client partners to align account needs and next stepsAssist and support the BDR in the coordination of onboarding activities for new accounts and support implementation tasks that help accounts transition smoothlyEnsure timely communication, documentation, and follow-up with internal stakeholders and external account contacts after visits, calls, and issue escalations

Client Engagement & Education

Educate account partners on available services, pharmacy processes, billing follow-up, and operational expectations to support effective collaborationCoordinate client-facing activities such as site visits, outreach, and immunization eventsShare observations from the field with internal teams and recommend practical solutions that reflect account needs, service trends, and operational realities

Performance Metrics (KPIs)

Success in this role will be measured through relationship strength, account retention, outreach consistency, growth, and operational follow-through across assigned accounts, including:

Account Retention and Growth: Retention rate of assigned accounts and continuity of service support to enact growth of this accountQuarterly Outreach Completion: Percentage of assigned accounts receiving scheduled visits or other quarterly touchpointsIssue Resolution Effectiveness: Timeliness and quality of follow-up on service, operational, and billing concernsBilling Follow-Up: Completion of invoice, statement, hard hold, and past-due follow-up activities assignedOnboarding Support: Successful coordination and follow-through for new account transitionsAccount Responsiveness: Timely communication and documented follow-up after visits, calls, and escalationsClient Satisfaction: Feedback from facilities, pharmacies, and partners regarding service support and relationship managementScheduling Effectiveness: Ability to maintain organized travel plans, account coverage, and regular contact across assigned territoriesOperational Support: Consistent coordination of site needs, flu clinic support, and account-related tasks in partnership with internal teams

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

Required Qualifications:

6+ months of experience building external client relationships and coordinating across internal teams to resolve issues and support account needs4+ years of experience supporting pharmacy or healthcare operations4+ years of experience in pharmacy or healthcare account management, in a client-facing support roleAccess to reliable transportation and valid US driver's license with the ability to travel regularly up to 75% of the time to customer sites while managing a structured field schedule

Preferred Qualifications:

Experience supporting residential, behavioral health, outpatient, substance use disorder, or other community-based healthcare accountsLicensed Pharmacy TechnicianExperience with invoice support, billing follow-up, account onboarding, or related operational coordination activitiesExperience coordinating healthcare related eventsProficiency with MS Office

Soft Skills:

Strong history of working with multiple stakeholders in a fast-paced healthcare environment, including the ability to multitask, problem-solve and prioritizeStrong organizational skills, including territory planning, visit scheduling, and documentation of account follow-up

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

        

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 $29 - $52 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

      

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

     

 

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

 

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

   

 

#RPO #RED

Read Less

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

The Nursing Facility Care Manager is responsible for facilitating, promoting, and advocating for the enrollees' ongoing self-sufficiency and independence. This position is responsible for assessment and planning for an identified group of patients in Nursing Facilities. Additionally, the care coordinator is responsible for assessing the availability of natural supports such as the enrollee's representative or family members to ensure the ongoing mental and physical health of those natural supports.

The Nursing Facility Care Manager collaborates with the Interdisciplinary Team to coordinate the delivery of comprehensive, efficient, cost-effective patient care. The Nursing Facility Care Manager will be traveling into nursing facilities, Adult Day Health, and Adult Living Facilities (ALF) to conduct in-depth assessments and develop the plan of care.

The Nursing Facility Care Manager actively assists enrollees with care transitions in collaboration with the Interdisciplinary Team and the acute or skilled facility staff, and the enrollees and / or the enrollees' representatives. The Nursing Facility Care Manager act as liaison between the Health Plan, the Commonwealth, enrollees, and their families.  

The Nursing Facility Care Manager follows established professional standards of care, Commonwealth guidelines and policy and procedures.

This is a field-based position visiting Nursing Facilities based in Western VA Markets. For consideration, you must reside within a commutable distance of Washington County, Grayson County and Smyth County VA Markets Alleghany or Rockbridge Counties in VA.

If you reside within a commutable distance of Madison, Charlottesville, Waynesboro, Fluvanna, or Staunton, VA Markets, you will have the flexibility to work remotely* as you take on some tough challenges. 

Primary Responsibilities:

Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needsDevelop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelinesPartner and collaborate with internal care team, providers, and community resources/partners to implement care planProvide education and coaching to support member self-management of care needs and lifestyle changes to promote healthSupport proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admissionAdvocate for members and families as needed to ensure the members' needs and choices are fully represented and supported by the health care team

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 and unrestricted Licensed Practical Nurse in the state of Virginia OR Social Work or Human Services (or related field) with a 4-year degree3+ years of care coordination or behavioral health experience and/or work in a healthcare environment 1+ years of experience with MS Office, including Word, Excel, and Outlook  Experience working with members who have medical needs, the elderly, individuals with physical disabilities and / or those who may have communication barriers  Access to reliable transportation and valid US driver's license with the ability to travel within assigned territory to meet with members and providers

Preferred Qualifications:

CCM certificationExperience working with Medicaid / Medicare populationExperience working in team-based careLong term care / geriatric experienceBackground in Managed Care

Physical Requirements:

Ability to transition from office to field locations multiple times per dayAbility to navigate multiple locations/terrains to visit employees, members and/or providersAbility to transport equipment to and from field locations needed for visits (ex. laptop, stethoscope, etc.)Ability to remain stationary for long periods of time to complete computer or tablet work duties

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

        

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 $24 - $43 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

      

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

     

 

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

 

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

   

 

#RPO #RED

Read Less