Registered Nurse Inpatient Case Manager Healthcare WellMed San Antonio Texas
2 weeks ago
If you are passionate about shaping the future of healthcare, this opportunity is for you. We are going above and beyond standard care to provide integrated health programs across the complete care spectrum. Join us in our journey of Care, Connection, and Growth
Job Description:
- Independently collaborate effectively with Interdisciplinary care team (ICT) to develop individualized transition plans for members
- Serve as the clinical liaison with hospital, clinical, and administrative staff
- Perform clinical reviews for inpatient care utilizing evidence-based criteria
- Communicate discharge needs, formulate plans, and provide benefit information
- Identify member risk levels and communicate transition plans
- Conduct onsite/telephonic assessments for transitioning members
- Efficiently manage assigned cases utilizing time management skills
- Maintain knowledge of utilization management and care coordination processes
- Enter accurate documentation into designated care management applications
- Adhere to organizational policies and procedures
- Maintain licensure and hospital credentialing
- Utilize population stratification tools for member assessment
- Refer cases to Medical Directors when necessary
- Monitor and report quality concerns
- Take on-call assignments as directed
Location:
Full-Time Office-IH10W/Field Base/Hybrid Position requiring travel around San Antonio and surrounding areas for onsite reviews of inpatient admissions
Qualifications:
- Bachelor's degree in Nursing or Associate's degree in Nursing with relevant experience
- Current, unrestricted RN license in the state of employment
- Case Management Certification (CCM) or ability to obtain within 12 months
- Diverse clinical experience in acute patient care
- Managed care and/or case management experience
- Knowledge of utilization management, quality improvement, and discharge planning
- Strong problem-solving skills and community resource identification
- Ability to meet physical and mental job requirements
Preferred Qualifications:
- Experience with psychiatric and geriatric populations
- Bilingual (English/Spanish) proficiency
- Critical thinking, nursing judgment, and decision-making skills
- Strong organizational and interpersonal skills
About Us:
At UnitedHealth Group, we strive to enhance people's well-being and improve the healthcare system. We are dedicated to providing equitable care, addressing health disparities, and promoting a healthier future for all.
Join us in creating a diverse and inclusive environment where everyone has the opportunity to thrive. We believe in equal employment opportunities and foster a workplace that values diversity and individual contributions.
Application Process:
Your journey towards a rewarding career starts here. Take the first step today
OptumCare is a drug-free workplace and all candidates must successfully pass a drug test before employment.-
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