Registered Nurse

3 weeks ago


Indianapolis, United States Professional Management Enterprises Full time
Job DescriptionJob Description

Primary Responsibilities:

  • Selects, manages, develops, mentors and supports staff in designated department or region
  • Develops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for results
  • In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements
  • Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements
  • Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence
  • Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care
  • Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services
  • Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
  • Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team
  • Participates in training and coaching of direct reports as needed
  • Conducts bi-annual field visits with direct reports to observe, provide areas of teaching, address issues and concerns and foster a good working relationship
  • Collaborates across Optum and UHG and interacted with Medical Directors, Site Directors, Senior Leaders, Network, Marketing, Account Management, Quality, Product, and other stakeholders

Required Qualifications:
•    Resident of Indiana
•    BSN or BSW with equivalent experience
•    Registered Nurse with an unrestricted License in Indiana
•    Experience working within the community health setting in a health care role
•    Experience or knowledge of Indiana Medicaid, Medicare, Long term care
•    Experience coaching or mentoring staff
•    Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment


Preferred Qualifications:
•    3+ year of case management leadership experience within a healthcare industry
•    Background in managed care
•    Case Management experience
•    Certified Case Manager (CCM)
•    Experience / exposure with members receiving long term social supports
•    Experience in utilization review, concurrent review and/or risk management
 

Company DescriptionProfessional Management Enterprises is a minority and veteran owned business that partners with major healthcare providers to find quality employees and thrives on helping people find positions that exceeds their expectations.Company DescriptionProfessional Management Enterprises is a minority and veteran owned business that partners with major healthcare providers to find quality employees and thrives on helping people find positions that exceeds their expectations.
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