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

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

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

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

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

 

 

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

 

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

Read Less

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

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

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

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

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

 

 

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

 

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

Read Less

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

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

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

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

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

 

 

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

 

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

Read Less

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

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

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

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

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

 

 

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

 

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

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

 

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

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

 

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) assurance of staffing higher volume hospitals and focusing the case managers on the standard work of command center; 2)  Productivity of case management teams; 3) Audit standard work 4) Produce daily, weekly and monthly operational metrics for the command center and 5) refocus team members on the tactics of the command center with report progress to the Sr. Medical Director

 

Primary Responsibilities:

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

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

Required Qualifications:

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

 

Preferred Qualification:

Bachelor's degree 

 

Working Conditions: 

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

Driving up to one hour per day.

 

Competencies for High Performers:   

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

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

 

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

 

 

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

 

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

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Optum 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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$7,500 Sign On Bonus for External Candidates

 

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

 

Location: Field based position throughout Seattle, WA

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

 

Primary Responsibilities:

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

 

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

Experience in a telephonic role

 

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

 

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

 

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

 

 

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

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

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

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

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

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

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

 

 

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

 

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

Read Less

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

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

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

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

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

 

 

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

 

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

Read Less

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

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

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

 

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

 

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

 

Primary Responsibilities:

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

 

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

Required Qualifications:

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

 

Preferred Qualifications:

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

 

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

 

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

 

 

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

 

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

Read Less

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

 

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

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

 

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) assurance of staffing higher volume hospitals and focusing the case managers on the standard work of command center; 2)  Productivity of case management teams; 3) Audit standard work 4) Produce daily, weekly and monthly operational metrics for the command center and 5) refocus team members on the tactics of the command center with report progress to the Sr. Medical Director

 

Primary Responsibilities:

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

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

Required Qualifications:

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

 

Preferred Qualification:

Bachelor's degree 

 

Working Conditions: 

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

Driving up to one hour per day.

 

Competencies for High Performers:   

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

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

 

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

 

 

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

 

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

Read Less

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

 

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

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

 

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) assurance of staffing higher volume hospitals and focusing the case managers on the standard work of command center; 2)  Productivity of case management teams; 3) Audit standard work 4) Produce daily, weekly and monthly operational metrics for the command center and 5) refocus team members on the tactics of the command center with report progress to the Sr. Medical Director

 

Primary Responsibilities:

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

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

Required Qualifications:

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

 

Preferred Qualification:

Bachelor's degree 

 

Working Conditions: 

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

Driving up to one hour per day.

 

Competencies for High Performers:   

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

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

 

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

 

 

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

 

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

Read Less

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

 

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

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

 

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) assurance of staffing higher volume hospitals and focusing the case managers on the standard work of command center; 2)  Productivity of case management teams; 3) Audit standard work 4) Produce daily, weekly and monthly operational metrics for the command center and 5) refocus team members on the tactics of the command center with report progress to the Sr. Medical Director

 

Primary Responsibilities:

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

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

Required Qualifications:

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

 

Preferred Qualification:

Bachelor's degree 

 

Working Conditions: 

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

Driving up to one hour per day.

 

Competencies for High Performers:   

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

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

 

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

 

 

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

 

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

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

 

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

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

 

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) assurance of staffing higher volume hospitals and focusing the case managers on the standard work of command center; 2)  Productivity of case management teams; 3) Audit standard work 4) Produce daily, weekly and monthly operational metrics for the command center and 5) refocus team members on the tactics of the command center with report progress to the Sr. Medical Director

 

Primary Responsibilities:

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

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

Required Qualifications:

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

 

Preferred Qualification:

Bachelor's degree 

 

Working Conditions: 

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

Driving up to one hour per day.

 

Competencies for High Performers:   

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

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

 

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

 

 

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

 

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

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Optum 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

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

 

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

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

 

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) assurance of staffing higher volume hospitals and focusing the case managers on the standard work of command center; 2)  Productivity of case management teams; 3) Audit standard work 4) Produce daily, weekly and monthly operational metrics for the command center and 5) refocus team members on the tactics of the command center with report progress to the Sr. Medical Director

 

Primary Responsibilities:

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

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

Required Qualifications:

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

 

Preferred Qualification:

Bachelor's degree 

 

Working Conditions: 

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

Driving up to one hour per day.

 

Competencies for High Performers:   

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

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

 

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

 

 

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

 

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

Read Less

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

 

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

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

 

Primary responsibility for case management includes discharge planning, improved transitions of care, and utilization management of long length hospitalized health plan members.  Ensure members receive quality medical care in the most appropriate setting.  Performs the following on a daily basis; 1) assurance of staffing higher volume hospitals and focusing the case managers on the standard work of command center; 2)  Productivity of case management teams; 3) Audit standard work 4) Produce daily, weekly and monthly operational metrics for the command center and 5) refocus team members on the tactics of the command center with report progress to the Sr. Medical Director

 

Primary Responsibilities:

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

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

Required Qualifications:

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

 

Preferred Qualification:

Bachelor's degree 

 

Working Conditions: 

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

Driving up to one hour per day.

 

Competencies for High Performers:   

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

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

 

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

 

 

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

 

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

Read Less