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

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

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

 

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

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$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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$7,500 Sign On Bonus for External Candidates

 

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

 

Location: Field based position throughout Seattle, WA

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

 

Primary Responsibilities:

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

 

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

Experience in a telephonic role

 

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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

 

 

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

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

Read Less

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.

 

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

This position has accountability and oversight the NV Medical Management Command Center RN case Manager functions.   Medical Management includes observation level patients,  acute long-term level patients and the development of plans of care to for transitions of care at discharge.  This positions is responsible for the daily operations of medical management case managers in the assigned facilities.  Collection and oversight of documentation and safety of RN decisions at discharge.  Education and training is an integral part of this position to promote patient care. As a manager lead IDT meetings, participate in taskforces and ensures coverage at large volume hospitals and high risk patients. There is direct responsibility for the development and maintainence of metric performance for the assigned areas of the position.  

 

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) assurance of staffing higher volume hospitals and focusing the case managers on the standard work of command center; 2)  Productivity of case management teams; 3) Audit standard work 4) Produce daily, weekly and monthly operational metrics for the command center and 5) refocus team members on the tactics of the command center with report progress to the Sr. Medical Director

 

Primary Responsibilities:

Ensure the team provides appropriate education, training, support and resources to all staff so that all compliance and customer service standards are met including the appropriateness of decision making, timeliness and completeness of all requestsProvide support to the team to allow for growth and development and encourage the team to think "out of the box" for solutionsIdentify barriers so that staff can maintain high productivity and high levels of moraleEnsure coordination between other internal departments as well as external companies as appropriateDevelop work plans and educational plans to best manage the day-to-day functions of multidisciplinary departmentsIndependently manage work flows including orientation, standard work and report concerns to the directorCollaborates on decisions to promote teamworkCollaboration with Sr. Medical Director and V.P.Promote LEAN work cycles for performance enhancementProvides input to leadership to enhance process flows and efficiencies while addressing initiatives, goals, and missionOther duties as assigned in medical management
 

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 licenseObtain CCM certification within 2+ years of employmentValid Nevada driver's license and maintain personal auto insurance coverage  1+ years of related professional experience in managed care environment1+ years related supervisory/management experience Solid knowledge of regulatory requirements, competent in case management business as well as clinical arenas Solid technology skills and excellent interpersonal skillsProven ability to negotiate and arbitrate without difficultyProven ability to supervise multiple levels of peopleCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care

 

Preferred Qualification:

Bachelor's degree 

 

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation setting or office to promote command center management

Driving up to one hour per day.

 

Competencies for High Performers:   

Participation in departmental projects assigned by Director or Manager.Certification in Case Management (CCM) or equivalent Professional Certification (ACM).Metric measures of success: Observation rate discharge, LOS Observation Rate; Observation rate of engagement with patient's high risk patients, improved readmission rate of high risk patients (10 days) and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note; Affordability measures 6 O'clock X matrix cost of care on engaged members.  Number of IDT completed within the week with Medical Director.
 

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 - $163,700 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.

Read Less

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.

 

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

This position has accountability and oversight the NV Medical Management Command Center RN case Manager functions.   Medical Management includes observation level patients,  acute long-term level patients and the development of plans of care to for transitions of care at discharge.  This positions is responsible for the daily operations of medical management case managers in the assigned facilities.  Collection and oversight of documentation and safety of RN decisions at discharge.  Education and training is an integral part of this position to promote patient care. As a manager lead IDT meetings, participate in taskforces and ensures coverage at large volume hospitals and high risk patients. There is direct responsibility for the development and maintainence of metric performance for the assigned areas of the position.  

 

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) assurance of staffing higher volume hospitals and focusing the case managers on the standard work of command center; 2)  Productivity of case management teams; 3) Audit standard work 4) Produce daily, weekly and monthly operational metrics for the command center and 5) refocus team members on the tactics of the command center with report progress to the Sr. Medical Director

 

Primary Responsibilities:

Ensure the team provides appropriate education, training, support and resources to all staff so that all compliance and customer service standards are met including the appropriateness of decision making, timeliness and completeness of all requestsProvide support to the team to allow for growth and development and encourage the team to think "out of the box" for solutionsIdentify barriers so that staff can maintain high productivity and high levels of moraleEnsure coordination between other internal departments as well as external companies as appropriateDevelop work plans and educational plans to best manage the day-to-day functions of multidisciplinary departmentsIndependently manage work flows including orientation, standard work and report concerns to the directorCollaborates on decisions to promote teamworkCollaboration with Sr. Medical Director and V.P.Promote LEAN work cycles for performance enhancementProvides input to leadership to enhance process flows and efficiencies while addressing initiatives, goals, and missionOther duties as assigned in medical management
 

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 licenseObtain CCM certification within 2+ years of employmentValid Nevada driver's license and maintain personal auto insurance coverage  1+ years of related professional experience in managed care environment1+ years related supervisory/management experience Solid knowledge of regulatory requirements, competent in case management business as well as clinical arenas Solid technology skills and excellent interpersonal skillsProven ability to negotiate and arbitrate without difficultyProven ability to supervise multiple levels of peopleCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care

 

Preferred Qualification:

Bachelor's degree 

 

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation setting or office to promote command center management

Driving up to one hour per day.

 

Competencies for High Performers:   

Participation in departmental projects assigned by Director or Manager.Certification in Case Management (CCM) or equivalent Professional Certification (ACM).Metric measures of success: Observation rate discharge, LOS Observation Rate; Observation rate of engagement with patient's high risk patients, improved readmission rate of high risk patients (10 days) and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note; Affordability measures 6 O'clock X matrix cost of care on engaged members.  Number of IDT completed within the week with Medical Director.
 

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 - $163,700 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.

Read Less

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.

 

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

This position has accountability and oversight the NV Medical Management Command Center RN case Manager functions.   Medical Management includes observation level patients,  acute long-term level patients and the development of plans of care to for transitions of care at discharge.  This positions is responsible for the daily operations of medical management case managers in the assigned facilities.  Collection and oversight of documentation and safety of RN decisions at discharge.  Education and training is an integral part of this position to promote patient care. As a manager lead IDT meetings, participate in taskforces and ensures coverage at large volume hospitals and high risk patients. There is direct responsibility for the development and maintainence of metric performance for the assigned areas of the position.  

 

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) assurance of staffing higher volume hospitals and focusing the case managers on the standard work of command center; 2)  Productivity of case management teams; 3) Audit standard work 4) Produce daily, weekly and monthly operational metrics for the command center and 5) refocus team members on the tactics of the command center with report progress to the Sr. Medical Director

 

Primary Responsibilities:

Ensure the team provides appropriate education, training, support and resources to all staff so that all compliance and customer service standards are met including the appropriateness of decision making, timeliness and completeness of all requestsProvide support to the team to allow for growth and development and encourage the team to think "out of the box" for solutionsIdentify barriers so that staff can maintain high productivity and high levels of moraleEnsure coordination between other internal departments as well as external companies as appropriateDevelop work plans and educational plans to best manage the day-to-day functions of multidisciplinary departmentsIndependently manage work flows including orientation, standard work and report concerns to the directorCollaborates on decisions to promote teamworkCollaboration with Sr. Medical Director and V.P.Promote LEAN work cycles for performance enhancementProvides input to leadership to enhance process flows and efficiencies while addressing initiatives, goals, and missionOther duties as assigned in medical management
 

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 licenseObtain CCM certification within 2+ years of employmentValid Nevada driver's license and maintain personal auto insurance coverage  1+ years of related professional experience in managed care environment1+ years related supervisory/management experience Solid knowledge of regulatory requirements, competent in case management business as well as clinical arenas Solid technology skills and excellent interpersonal skillsProven ability to negotiate and arbitrate without difficultyProven ability to supervise multiple levels of peopleCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care

 

Preferred Qualification:

Bachelor's degree 

 

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation setting or office to promote command center management

Driving up to one hour per day.

 

Competencies for High Performers:   

Participation in departmental projects assigned by Director or Manager.Certification in Case Management (CCM) or equivalent Professional Certification (ACM).Metric measures of success: Observation rate discharge, LOS Observation Rate; Observation rate of engagement with patient's high risk patients, improved readmission rate of high risk patients (10 days) and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note; Affordability measures 6 O'clock X matrix cost of care on engaged members.  Number of IDT completed within the week with Medical Director.
 

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 - $163,700 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.

Read Less

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.

 

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

This position has accountability and oversight the NV Medical Management Command Center RN case Manager functions.   Medical Management includes observation level patients,  acute long-term level patients and the development of plans of care to for transitions of care at discharge.  This positions is responsible for the daily operations of medical management case managers in the assigned facilities.  Collection and oversight of documentation and safety of RN decisions at discharge.  Education and training is an integral part of this position to promote patient care. As a manager lead IDT meetings, participate in taskforces and ensures coverage at large volume hospitals and high risk patients. There is direct responsibility for the development and maintainence of metric performance for the assigned areas of the position.  

 

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) assurance of staffing higher volume hospitals and focusing the case managers on the standard work of command center; 2)  Productivity of case management teams; 3) Audit standard work 4) Produce daily, weekly and monthly operational metrics for the command center and 5) refocus team members on the tactics of the command center with report progress to the Sr. Medical Director

 

Primary Responsibilities:

Ensure the team provides appropriate education, training, support and resources to all staff so that all compliance and customer service standards are met including the appropriateness of decision making, timeliness and completeness of all requestsProvide support to the team to allow for growth and development and encourage the team to think "out of the box" for solutionsIdentify barriers so that staff can maintain high productivity and high levels of moraleEnsure coordination between other internal departments as well as external companies as appropriateDevelop work plans and educational plans to best manage the day-to-day functions of multidisciplinary departmentsIndependently manage work flows including orientation, standard work and report concerns to the directorCollaborates on decisions to promote teamworkCollaboration with Sr. Medical Director and V.P.Promote LEAN work cycles for performance enhancementProvides input to leadership to enhance process flows and efficiencies while addressing initiatives, goals, and missionOther duties as assigned in medical management
 

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 licenseObtain CCM certification within 2+ years of employmentValid Nevada driver's license and maintain personal auto insurance coverage  1+ years of related professional experience in managed care environment1+ years related supervisory/management experience Solid knowledge of regulatory requirements, competent in case management business as well as clinical arenas Solid technology skills and excellent interpersonal skillsProven ability to negotiate and arbitrate without difficultyProven ability to supervise multiple levels of peopleCritical Thinking: Proven ability to integrate guidelines/tools to negotiate most effective plan of care

 

Preferred Qualification:

Bachelor's degree 

 

Working Conditions: 

Work completed in acute hospital and/or sub-acute and/or Inpatient Rehabilitation setting or office to promote command center management

Driving up to one hour per day.

 

Competencies for High Performers:   

Participation in departmental projects assigned by Director or Manager.Certification in Case Management (CCM) or equivalent Professional Certification (ACM).Metric measures of success: Observation rate discharge, LOS Observation Rate; Observation rate of engagement with patient's high risk patients, improved readmission rate of high risk patients (10 days) and engagement of PCP HFU rate, daily productivity 10-11 patients per day OBs note; Affordability measures 6 O'clock X matrix cost of care on engaged members.  Number of IDT completed within the week with Medical Director.
 

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 - $163,700 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 AZ is seeking a RN Case Manager to join our team in Phoenix, AZ. 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 Clinic Case Manager is responsible for fostering collaboration and a team approach for successfully supporting patients with high-risk health conditions to navigate the healthcare system. Promotes empowerment by facilitating the role of an educator, resource, and advocate for patients and their families to ensure a maximum quality of life. Interacts and collaborates with multidisciplinary care teams, to include physicians, nurses, pharmacists, case managers, social workers, and other educators. Acts as a clinic resource for the value-based population. Works in a less structured, self-directed environment and performs all delegated nursing duties within the scope of a RN license of the applicable state board of nursing.

 

Ensures compliance to contractual and service standards as identified by relevant health insurance plans.  Adheres to policies, procedures, and regulations to ensure compliance and patient safety. Participation in Compliance and required training is a condition of employment.

 

Primary Responsibilities:

Role embedded within the primary care clinic, working directly with patients, clinical and non-clinical teamsParticipates in the identification of a focused clinic patient panel, as defined by the Chief Medical OfficerSupports longitudinal care of the patient with chronic care conditionsCommunicates with patients, responding to patient questions via patient portal and other modalitiesPerforms assessment of health conditions and implements care plan in collaboration with the member, caregiver(s), clinician(s), and/or other appropriate healthcare professionals to address need and goalsPursues appropriate interventions to reduce risk of condition exacerbation, ER and hospitalization utilizationPerforms medication reconciliation and collaborates with clinician partner as neededConducts Motivational Interviewing and Self-Management Goal settingProvides patient educationCreates referrals to appropriate agencies and resourcesSupports transition of care from Emergency Department or inpatient stay to outpatient settingPerforms assessment of transitional needsPerforms medication reconciliationEstablishes and reviews contingency planProvides patient educationAssists with post discharge needs such as home health care, prescriptions, transportation, Durable Medical Equipment (DME), appointmentsCoordinates with providers to establish or update individualized plan of careCreates referrals to appropriate internal and external resourcesAchieves Quality Measures outcomes via reduction in HEDIS Gaps in CarePerforms accurate and timely documentation in the electronic medical recordPerforms triage and clinical tasks within their scope of practiceParticipates in daily huddles and monthly clinic meetings, as requiredPrepares accurate and timely reports, as requiredMaintains continued competence in nursing practice and knowledge of current evidence-based practicesPerforms ongoing updates of the care plan to evaluate effectiveness, and to document interventions and goal achievementMaintains a working knowledge of community resourcesServes as facilitator and resource for other members of the Medical Group clinical teamAttends departmental meetings and provides constructive recommendations for process improvementPerforms other duties as assigned

 

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:

Valid AZ RN LicenseCurrent BLS Certification3+ years of job-related experience in a healthcare environmentKnowledge of medical terminologyProven skilled with MS Office software applicationsProven excellent communication, interpersonal, organization and customer service skillsProven self-motivated, solid computer skillsProven attention to detailProven ability to multi-task and work under pressureValid AZ State Driver's license and access to reliable transportation

 

Preferred Qualifications:

Bachelor's degree or higher in healthcare related field2+ years of experience providing prior authorization or case management within health plan or integrated system

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

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

 

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

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Optum AZ is seeking a RN Case Manager to join our team in Phoenix, AZ. 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 Clinic Case Manager is responsible for fostering collaboration and a team approach for successfully supporting patients with high-risk health conditions to navigate the healthcare system. Promotes empowerment by facilitating the role of an educator, resource, and advocate for patients and their families to ensure a maximum quality of life. Interacts and collaborates with multidisciplinary care teams, to include physicians, nurses, pharmacists, case managers, social workers, and other educators. Acts as a clinic resource for the value-based population. Works in a less structured, self-directed environment and performs all delegated nursing duties within the scope of a RN license of the applicable state board of nursing.

 

Ensures compliance to contractual and service standards as identified by relevant health insurance plans.  Adheres to policies, procedures, and regulations to ensure compliance and patient safety. Participation in Compliance and required training is a condition of employment.

 

Primary Responsibilities:

Role embedded within the primary care clinic, working directly with patients, clinical and non-clinical teamsParticipates in the identification of a focused clinic patient panel, as defined by the Chief Medical OfficerSupports longitudinal care of the patient with chronic care conditionsCommunicates with patients, responding to patient questions via patient portal and other modalitiesPerforms assessment of health conditions and implements care plan in collaboration with the member, caregiver(s), clinician(s), and/or other appropriate healthcare professionals to address need and goalsPursues appropriate interventions to reduce risk of condition exacerbation, ER and hospitalization utilizationPerforms medication reconciliation and collaborates with clinician partner as neededConducts Motivational Interviewing and Self-Management Goal settingProvides patient educationCreates referrals to appropriate agencies and resourcesSupports transition of care from Emergency Department or inpatient stay to outpatient settingPerforms assessment of transitional needsPerforms medication reconciliationEstablishes and reviews contingency planProvides patient educationAssists with post discharge needs such as home health care, prescriptions, transportation, Durable Medical Equipment (DME), appointmentsCoordinates with providers to establish or update individualized plan of careCreates referrals to appropriate internal and external resourcesAchieves Quality Measures outcomes via reduction in HEDIS Gaps in CarePerforms accurate and timely documentation in the electronic medical recordPerforms triage and clinical tasks within their scope of practiceParticipates in daily huddles and monthly clinic meetings, as requiredPrepares accurate and timely reports, as requiredMaintains continued competence in nursing practice and knowledge of current evidence-based practicesPerforms ongoing updates of the care plan to evaluate effectiveness, and to document interventions and goal achievementMaintains a working knowledge of community resourcesServes as facilitator and resource for other members of the Medical Group clinical teamAttends departmental meetings and provides constructive recommendations for process improvementPerforms other duties as assigned

 

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:

Valid AZ RN LicenseCurrent BLS Certification3+ years of job-related experience in a healthcare environmentKnowledge of medical terminologyProven skilled with MS Office software applicationsProven excellent communication, interpersonal, organization and customer service skillsProven self-motivated, solid computer skillsProven attention to detailProven ability to multi-task and work under pressureValid AZ State Driver's license and access to reliable transportation

 

Preferred Qualifications:

Bachelor's degree or higher in healthcare related field2+ years of experience providing prior authorization or case management within health plan or integrated system

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

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

 

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

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

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

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

 

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

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

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

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

 

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

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

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

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

 

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

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

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

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

 

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

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Explore opportunities with Elite Hospice, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.

As the Hospice Registered Nurse Case Manager, you will assume full nursing responsibility for the delivery of the Plan of Care for each hospice patient. Continuously evaluating personal and professional performance and making necessary changes to increase productivity and quality of care delivered. You'll also develop the patient's Plan of care in collaboration with other professionals and implement treatment strategies based on scientific nursing theory that promotes physical, psychosocial, emotional, and spiritual well-being.  Familiar with the concepts and needs of patients/families who are facing death and dying.

Primary Responsibilities:

Makes the initial nursing evaluation in determining eligibility for hospice services during visit within forty-eight (48) hours of referralIdentifies the patient's/family's physical, psychosocial, and environmental needs and re-assesses as needed, no less than every fifteen (15) daysInitiates and coordinates the plan of careDocuments problems, appropriate goals, interventions, and patient/family response to hospice careCollaborates with the patient/family, attending physician and other members of the IDG in providing patient and family care dailyInstructs and supervises the patient/family in self-care techniques when appropriate

Maintains accurate and relevant clinical notes regarding the patient's condition

 

Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client  
 

 

 

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 and unrestricted RN licensure in the state of practice 

 

Current driver's license, valid vehicle insurance, and access to a dependable vehicle, or public transportation

 

Preferred Qualifications:

1+ years of clinical experience Current CPR certification or ability to complete within 90 days of hire  

 

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 $83,580 to $125,370 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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


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


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

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$10,000 Sign-on Bonus  for External Candidates 

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

 

Optum NY, is seeking a Registered Nurse Manager Gastroenterology to join our team in Lake Success, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

 

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

 

Position details:

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

 

Primary responsibilities:

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

 

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

 

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

Required Qualifications:

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

 

Preferred Qualifications: 

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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

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

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$10,000 Sign-on Bonus for External Candidates

 

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

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

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

 

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

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

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

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

 

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

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

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

 

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

 

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

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