Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)
Registered Nurse Case Manager is responsible for developing and implementing the outpatient diabetes program for Optum.
- Consistently exhibits behavior and communication skills that demonstrate our company's commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
- Prioritizes patient care needs upon initial visit and addresses emerging issues.
- Meets with patients, patients’ family and caregivers as needed to discuss care and treatment plan.
- Identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings.
- Consults with physician and other team members to ensure that care plan is successfully implemented.
- Coordinates treatment plans with the care team and triages interventions appropriate to the skill set of the team members.
- Uses protocols and pathways in line with established disease management and care management programs and approved by medical management in order to optimize clinical outcomes.
- Monitors and coaches patients using techniques of motivational interviewing and behavioral change to maximize self-management.
- Oversees provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc., in order to maintain continuity of care.
- Works in coordination with the care team and demonstrates accountability with patient management and outcome.
- Discusses Durable Power of Attorney (DPoA) and advanced directive status with PCP when applicable.
- Maintains effective communication with the physicians, hospitalists, extended care facilities, patients and families.
- Provides accurate information to patients and families regarding HMO benefits, community resources, referrals and other related issues.
- Participates actively in assigned Care Management Coordination Committee (CMCC) meetings.
- Documents pertinent patient information and Care Management Plan in Electronic Health Record and Care Management Systems as appropriate.
- Coordinates care with central departments on assigned patient caseload, including out-of-area, inpatient central and transplant.
- Adheres to departmental policies and procedures as approved by Office of the Medical Director (OMD) Quality Committee.
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.
- Graduation from an accredited school of nursing
- Active, unrestricted Registered Nurse license through the State of California
- Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross)
- 3+ years of experience in a clinical setting
- Bachelor of Science in Nursing, BSN
- Telehealth certification
- 3+ years of experience working in acute care
- 1+ year(s) Previous care management, utilization review or discharge planning experience
- HMO Experience
Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)
OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.
California Residents Only: The salary range for California residents is $56,300 to $110,400. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
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.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment