$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.

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. Promote 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. 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 teams providing transitional case management servicesPerforms assessment/screening of health conditions; 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 utilization to meet department/organization metrics or goalsSupports transition of care from Emergency Department or inpatient stay to outpatient setting. Assist with referrals (home health/DME) and appointments (PCP/specialist)Achieves Quality Measures outcomes via reduction in HEDIS Gaps in Care

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

Required Qualifications:

Valid NV RN LicenseCurrent BLS Certification or willingness to obtain within 3 months of hire2+ years of job-related experience in an acute care settingKnowledge of medical terminology; nursing assessment and follow up on patient's needsProven skilled with MS Office software applications and electronic medical records (EMR)Proven excellent communication, interpersonal, organization and customer service skillsPositive personality and willingness to effect changeProven ability to multi-task and work under pressureValid NV State Driver's license and access to reliable transportation

Preferred Qualifications:

Bachelor's degree or higher in nursing3+ years of experience providing hospital care (ICU/Floor) or Emergency room (ED) nurse or case management within Hospital/Clinic/Practice

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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

 

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

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

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$10,000 Sign On Bonus for External Candidates

 

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

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

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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

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

Read Less

$10,000 Sign-on Bonus for External Candidates

 

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.

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. Promote 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. 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 teams providing transitional case management servicesPerforms assessment/screening of health conditions; 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 utilization to meet department/organization metrics or goalsSupports transition of care from Emergency Department or inpatient stay to outpatient setting. Assist with referrals (home health/DME) and appointments (PCP/specialist)Achieves Quality Measures outcomes via reduction in HEDIS Gaps in Care

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

Required Qualifications:

Valid NV RN LicenseCurrent BLS Certification or willingness to obtain within 3 months of hire2+ years of job-related experience in an acute care settingKnowledge of medical terminology; nursing assessment and follow up on patient's needsProven skilled with MS Office software applications and electronic medical records (EMR)Proven excellent communication, interpersonal, organization and customer service skillsPositive personality and willingness to effect changeProven ability to multi-task and work under pressureValid NV State Driver's license and access to reliable transportation

Preferred Qualifications:

Bachelor's degree or higher in nursing3+ years of experience providing hospital care (ICU/Floor) or Emergency room (ED) nurse or case management within Hospital/Clinic/Practice

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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

$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.

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. Promote 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. 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 teams providing transitional case management servicesPerforms assessment/screening of health conditions; 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 utilization to meet department/organization metrics or goalsSupports transition of care from Emergency Department or inpatient stay to outpatient setting. Assist with referrals (home health/DME) and appointments (PCP/specialist)Achieves Quality Measures outcomes via reduction in HEDIS Gaps in Care

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

Required Qualifications:

Valid NV RN LicenseCurrent BLS Certification or willingness to obtain within 3 months of hire2+ years of job-related experience in an acute care settingKnowledge of medical terminology; nursing assessment and follow up on patient's needsProven skilled with MS Office software applications and electronic medical records (EMR)Proven excellent communication, interpersonal, organization and customer service skillsPositive personality and willingness to effect changeProven ability to multi-task and work under pressureValid NV State Driver's license and access to reliable transportation

Preferred Qualifications:

Bachelor's degree or higher in nursing3+ years of experience providing hospital care (ICU/Floor) or Emergency room (ED) nurse or case management within Hospital/Clinic/Practice

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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

$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.

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. Promote 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. 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 teams providing transitional case management servicesPerforms assessment/screening of health conditions; 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 utilization to meet department/organization metrics or goalsSupports transition of care from Emergency Department or inpatient stay to outpatient setting. Assist with referrals (home health/DME) and appointments (PCP/specialist)Achieves Quality Measures outcomes via reduction in HEDIS Gaps in Care

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

Required Qualifications:

Valid NV RN LicenseCurrent BLS Certification or willingness to obtain within 3 months of hire2+ years of job-related experience in an acute care settingKnowledge of medical terminology; nursing assessment and follow up on patient's needsProven skilled with MS Office software applications and electronic medical records (EMR)Proven excellent communication, interpersonal, organization and customer service skillsPositive personality and willingness to effect changeProven ability to multi-task and work under pressureValid NV State Driver's license and access to reliable transportation

Preferred Qualifications:

Bachelor's degree or higher in nursing3+ years of experience providing hospital care (ICU/Floor) or Emergency room (ED) nurse or case management within Hospital/Clinic/Practice

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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

$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.

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. Promote 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. 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 teams providing transitional case management servicesPerforms assessment/screening of health conditions; 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 utilization to meet department/organization metrics or goalsSupports transition of care from Emergency Department or inpatient stay to outpatient setting. Assist with referrals (home health/DME) and appointments (PCP/specialist)Achieves Quality Measures outcomes via reduction in HEDIS Gaps in Care

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

Required Qualifications:

Valid NV RN LicenseCurrent BLS Certification or willingness to obtain within 3 months of hire2+ years of job-related experience in an acute care settingKnowledge of medical terminology; nursing assessment and follow up on patient's needsProven skilled with MS Office software applications and electronic medical records (EMR)Proven excellent communication, interpersonal, organization and customer service skillsPositive personality and willingness to effect changeProven ability to multi-task and work under pressureValid NV State Driver's license and access to reliable transportation

Preferred Qualifications:

Bachelor's degree or higher in nursing3+ years of experience providing hospital care (ICU/Floor) or Emergency room (ED) nurse or case management within Hospital/Clinic/Practice

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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

$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.

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. Promote 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. 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 teams providing transitional case management servicesPerforms assessment/screening of health conditions; 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 utilization to meet department/organization metrics or goalsSupports transition of care from Emergency Department or inpatient stay to outpatient setting. Assist with referrals (home health/DME) and appointments (PCP/specialist)Achieves Quality Measures outcomes via reduction in HEDIS Gaps in Care

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

Required Qualifications:

Valid NV RN LicenseCurrent BLS Certification or willingness to obtain within 3 months of hire2+ years of job-related experience in an acute care settingKnowledge of medical terminology; nursing assessment and follow up on patient's needsProven skilled with MS Office software applications and electronic medical records (EMR)Proven excellent communication, interpersonal, organization and customer service skillsPositive personality and willingness to effect changeProven ability to multi-task and work under pressureValid NV State Driver's license and access to reliable transportation

Preferred Qualifications:

Bachelor's degree or higher in nursing3+ years of experience providing hospital care (ICU/Floor) or Emergency room (ED) nurse or case management within Hospital/Clinic/Practice

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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

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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$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.

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. Promote 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. 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 teams providing transitional case management servicesPerforms assessment/screening of health conditions; 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 utilization to meet department/organization metrics or goalsSupports transition of care from Emergency Department or inpatient stay to outpatient setting. Assist with referrals (home health/DME) and appointments (PCP/specialist)Achieves Quality Measures outcomes via reduction in HEDIS Gaps in Care

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

Required Qualifications:

Valid NV RN LicenseCurrent BLS Certification or willingness to obtain within 3 months of hire2+ years of job-related experience in an acute care settingKnowledge of medical terminology; nursing assessment and follow up on patient's needsProven skilled with MS Office software applications and electronic medical records (EMR)Proven excellent communication, interpersonal, organization and customer service skillsPositive personality and willingness to effect changeProven ability to multi-task and work under pressureValid NV State Driver's license and access to reliable transportation

Preferred Qualifications:

Bachelor's degree or higher in nursing3+ years of experience providing hospital care (ICU/Floor) or Emergency room (ED) nurse or case management within Hospital/Clinic/Practice

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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. 

Read Less

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

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

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

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

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

 

 

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

 

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

Read Less

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

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

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

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

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

 

 

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

 

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

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

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

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

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

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

 

 

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

 

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

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$10,000 Sign On Bonus for External Candidates

 

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

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

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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

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

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Come join us for our upcoming virtual hiring event!

Event Date & Time: Tuesday, July 14th at 12:00pm EST  Florida Care Managers & Care Review Clinicians Virtual Hiring Event

Event Date & Time: Thursday, July 23rd at 12:00pm EST Florida Care Managers & Care Review Clinicians Virtual Hiring Event

 

JOB DESCRIPTION 

Job Summary

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

Must reside in the following counties:

Region A: Escambia, Santa Rosa, Washington, Gadsden, Leon, Bay, Okaloosa, Walton, Wakulla, Jackson, Jefferson, Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton, Washington Region B: Duval, Hernando, Lake, Marion, Volusia, Alachua, Columbia, St. Johns, Flagler, Citrus, Suwannee, Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dizie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Nassau, Putnam, St John's, Sumter, Suwannee, Union, Volusia Region C: Pasco, Pinellas Region D: Hardee, Highlands, Hilssborough, Manatee, Polk - but highest volumes to be in Hillsborough, Manatee, and Polk Region E: Seminole, Orange, Osceola, Brevard Region F: Charlotte, Collier, Desoto, Glades, Hendry, lee, Sarasota) - but highest volumes to be in Collier, Lee, and Hendry Region G: Indian River, Martin, Okeechobee, Palm Beach, and St Lucie )- but highest volumes in Palm Beach, St Lucie, Indian River, and Martin Region H: Broward Region I: Miami-Dade, Monroe

 

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

 

Required Qualifications
• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. 
• Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. 
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. 
• Demonstrated knowledge of community resources. 
• Ability to operate proactively and demonstrate detail-oriented work. 
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. 
• Ability to work independently, with minimal supervision and self-motivation. 
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. 
• Ability to develop and maintain professional relationships. 
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. 
• Excellent problem-solving and critical-thinking skills. 
• Strong verbal and written communication skills. 
• Microsoft Office suite/applicable software program(s) proficiency. 
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).

 

Preferred Qualifications

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

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

#PJHS

#HTF

#LI-AC1

Pay Range: $24 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Read Less

Come join us for our upcoming virtual hiring event!

Event Date & Time: Tuesday, July 14th at 12:00pm EST  Florida Care Managers & Care Review Clinicians Virtual Hiring Event

Event Date & Time: Thursday, July 23rd at 12:00pm EST Florida Care Managers & Care Review Clinicians Virtual Hiring Event

 

JOB DESCRIPTION 

Job Summary

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

Must reside in the following counties:

Region A: Escambia, Santa Rosa, Washington, Gadsden, Leon, Bay, Okaloosa, Walton, Wakulla, Jackson, Jefferson, Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton, Washington Region B: Duval, Hernando, Lake, Marion, Volusia, Alachua, Columbia, St. Johns, Flagler, Citrus, Suwannee, Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dizie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Nassau, Putnam, St John's, Sumter, Suwannee, Union, Volusia Region C: Pasco, Pinellas Region D: Hardee, Highlands, Hilssborough, Manatee, Polk - but highest volumes to be in Hillsborough, Manatee, and Polk Region E: Seminole, Orange, Osceola, Brevard Region F: Charlotte, Collier, Desoto, Glades, Hendry, lee, Sarasota) - but highest volumes to be in Collier, Lee, and Hendry Region G: Indian River, Martin, Okeechobee, Palm Beach, and St Lucie )- but highest volumes in Palm Beach, St Lucie, Indian River, and Martin Region H: Broward Region I: Miami-Dade, Monroe

 

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

 

Required Qualifications
• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. 
• Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. 
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. 
• Demonstrated knowledge of community resources. 
• Ability to operate proactively and demonstrate detail-oriented work. 
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. 
• Ability to work independently, with minimal supervision and self-motivation. 
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. 
• Ability to develop and maintain professional relationships. 
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. 
• Excellent problem-solving and critical-thinking skills. 
• Strong verbal and written communication skills. 
• Microsoft Office suite/applicable software program(s) proficiency. 
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).

 

Preferred Qualifications

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

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

#PJHS

#HTF

#LI-AC1

Pay Range: $24 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Read Less

Come join us for our upcoming virtual hiring event!

Event Date & Time: Tuesday, July 14th at 12:00pm EST  Florida Care Managers & Care Review Clinicians Virtual Hiring Event

Event Date & Time: Thursday, July 23rd at 12:00pm EST Florida Care Managers & Care Review Clinicians Virtual Hiring Event

 

JOB DESCRIPTION 

Job Summary

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

Must reside in the following counties:

Region A: Escambia, Santa Rosa, Washington, Gadsden, Leon, Bay, Okaloosa, Walton, Wakulla, Jackson, Jefferson, Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton, Washington Region B: Duval, Hernando, Lake, Marion, Volusia, Alachua, Columbia, St. Johns, Flagler, Citrus, Suwannee, Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dizie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Nassau, Putnam, St John's, Sumter, Suwannee, Union, Volusia Region C: Pasco, Pinellas Region D: Hardee, Highlands, Hilssborough, Manatee, Polk - but highest volumes to be in Hillsborough, Manatee, and Polk Region E: Seminole, Orange, Osceola, Brevard Region F: Charlotte, Collier, Desoto, Glades, Hendry, lee, Sarasota) - but highest volumes to be in Collier, Lee, and Hendry Region G: Indian River, Martin, Okeechobee, Palm Beach, and St Lucie )- but highest volumes in Palm Beach, St Lucie, Indian River, and Martin Region H: Broward Region I: Miami-Dade, Monroe

 

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

 

Required Qualifications
• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. 
• Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. 
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. 
• Demonstrated knowledge of community resources. 
• Ability to operate proactively and demonstrate detail-oriented work. 
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. 
• Ability to work independently, with minimal supervision and self-motivation. 
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. 
• Ability to develop and maintain professional relationships. 
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. 
• Excellent problem-solving and critical-thinking skills. 
• Strong verbal and written communication skills. 
• Microsoft Office suite/applicable software program(s) proficiency. 
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).

 

Preferred Qualifications

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

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

#PJHS

#HTF

#LI-AC1

Pay Range: $24 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Read Less

Come join us for our upcoming virtual hiring event!

Event Date & Time: Tuesday, July 14th at 12:00pm EST  Florida Care Managers & Care Review Clinicians Virtual Hiring Event

Event Date & Time: Thursday, July 23rd at 12:00pm EST Florida Care Managers & Care Review Clinicians Virtual Hiring Event

 

JOB DESCRIPTION 

Job Summary

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

Must reside in the following counties:

Region A: Escambia, Santa Rosa, Washington, Gadsden, Leon, Bay, Okaloosa, Walton, Wakulla, Jackson, Jefferson, Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton, Washington Region B: Duval, Hernando, Lake, Marion, Volusia, Alachua, Columbia, St. Johns, Flagler, Citrus, Suwannee, Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dizie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Nassau, Putnam, St John's, Sumter, Suwannee, Union, Volusia Region C: Pasco, Pinellas Region D: Hardee, Highlands, Hilssborough, Manatee, Polk - but highest volumes to be in Hillsborough, Manatee, and Polk Region E: Seminole, Orange, Osceola, Brevard Region F: Charlotte, Collier, Desoto, Glades, Hendry, lee, Sarasota) - but highest volumes to be in Collier, Lee, and Hendry Region G: Indian River, Martin, Okeechobee, Palm Beach, and St Lucie )- but highest volumes in Palm Beach, St Lucie, Indian River, and Martin Region H: Broward Region I: Miami-Dade, Monroe

 

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

 

Required Qualifications
• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. 
• Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. 
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. 
• Demonstrated knowledge of community resources. 
• Ability to operate proactively and demonstrate detail-oriented work. 
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. 
• Ability to work independently, with minimal supervision and self-motivation. 
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. 
• Ability to develop and maintain professional relationships. 
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. 
• Excellent problem-solving and critical-thinking skills. 
• Strong verbal and written communication skills. 
• Microsoft Office suite/applicable software program(s) proficiency. 
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).

 

Preferred Qualifications

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

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

#PJHS

#HTF

#LI-AC1

Pay Range: $24 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Read Less

Come join us for our upcoming virtual hiring event!

Event Date & Time: Tuesday, July 14th at 12:00pm EST  Florida Care Managers & Care Review Clinicians Virtual Hiring Event

Event Date & Time: Thursday, July 23rd at 12:00pm EST Florida Care Managers & Care Review Clinicians Virtual Hiring Event

 

JOB DESCRIPTION 

Job Summary

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

Must reside in the following counties:

Region A: Escambia, Santa Rosa, Washington, Gadsden, Leon, Bay, Okaloosa, Walton, Wakulla, Jackson, Jefferson, Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton, Washington Region B: Duval, Hernando, Lake, Marion, Volusia, Alachua, Columbia, St. Johns, Flagler, Citrus, Suwannee, Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dizie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Nassau, Putnam, St John's, Sumter, Suwannee, Union, Volusia Region C: Pasco, Pinellas Region D: Hardee, Highlands, Hilssborough, Manatee, Polk - but highest volumes to be in Hillsborough, Manatee, and Polk Region E: Seminole, Orange, Osceola, Brevard Region F: Charlotte, Collier, Desoto, Glades, Hendry, lee, Sarasota) - but highest volumes to be in Collier, Lee, and Hendry Region G: Indian River, Martin, Okeechobee, Palm Beach, and St Lucie )- but highest volumes in Palm Beach, St Lucie, Indian River, and Martin Region H: Broward Region I: Miami-Dade, Monroe

 

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

 

Required Qualifications
• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. 
• Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. 
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. 
• Demonstrated knowledge of community resources. 
• Ability to operate proactively and demonstrate detail-oriented work. 
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. 
• Ability to work independently, with minimal supervision and self-motivation. 
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. 
• Ability to develop and maintain professional relationships. 
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. 
• Excellent problem-solving and critical-thinking skills. 
• Strong verbal and written communication skills. 
• Microsoft Office suite/applicable software program(s) proficiency. 
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).

 

Preferred Qualifications

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

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

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Pay Range: $24 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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