Case Manager

2 weeks ago

DALLAS, United States Optum Full time

WellMed, part of the Optum family of businesses, is seeking a Case Manager, LVN or LPN - WellMed at University to join our team in Dallas, TX. 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. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together


 


The Nurse Case Manager I (NCM) is responsible for patient case management for longitudinal engagement, coordination for discharge planning, transition of care needs and outpatient patient management through the care continuum. The Nurse Care Manager will determine medical appropriateness of outpatient services following evaluation of medical guidelines and benefit determination. The Nurse Case Manager will coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for patients. This role acts as a support to team members, coaching, guiding and providing feedback as necessary. The Nurse Case Manager will act as an advocate for patients and their families guide them through the health care system for transition planning and longitudinal care. The Nurse Case Manager will work in partnership with an assigned Care Advocate and Social Worker.


 


Primary Responsibilities:



  • Engage patient, family, and caregivers telephonically to assure that a well-coordinated action plan is established and continually assess health status
  • Provide member education to assist with self-management goals; disease management or acute condition and provide indicated contingency plan
  • Identify patient needs, close health care gaps, develop action plan and prioritize goals
  • With oversight of RN and/or MD, utilizing evidence-based practice, develop interventions while considering member barriers independently
  • Provide patients with ‘welcome home‘ calls to ensure that discharged patients’ receive the necessary services and resources according to transition plan
  • In partnership with care team triad, make referrals to community sources and programs identified for patients
  • Utilize motivational interviewing techniques to understand cause and effect, gather or review health history for clinical symptoms, and determine health literacy
  • Manages assessments regarding patient treatment plans and establish collaborative relationships with physician advisors, clients, patients, and providers
  • Collaborates effectively with Interdisciplinary Care Team (IDCT) to establish an individualized transition plan and/or action plan for patients
  • Independently confers with UM Medical Directors and/ or Market Medical Directors on a regular basis regarding inpatient cases and participates in departmental huddles
  • Demonstrate knowledge of utilization management processes and current standards of care as a foundation for utilization review and transition planning activities
  • Maintain in-depth knowledge of all company products and services as well as customer issues and needs through ongoing training and self-directed research 
  • Manage assigned caseload in an efficient and effective manner utilizing time management skills
  • Enters timely and accurate documentation into designated care management applications to comply with documentation requirements and achieve audit scores of 95% or better on 
    a monthly basis
  • Maintain current licensure to work in state of employment and maintain hospital credentialing as indicated
  • Performs all other related duties as assigned

 


In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors’ offices. At WellMed our focus is simple. We’re innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000+ primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000+ older adults. Together, we‘re making health care work better for everyone.


 


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:



  • Licensed Practical/Vocational Nurse
  • Current, unrestricted LPN/LVN license required, specific to the state of employment
  • 2+ years of managed care and/or case management experience
  • 2+ years of clinical experience
  • Knowledge of managed care, medical terminology, referral process, claims and ICD-10 codes.
  • Proven excellent verbal and written skills

 


Preferred Qualifications:



  • Case Management certification
  • Knowledge of utilization management and/or insurance review processes as well as current standards of care, a solid knowledge of health care delivery systems and the ability to interact with medical directors, physician advisors, clinicians and support staff
  • Proficient computer skills in Microsoft applications and Microsoft Excel
  • Proven skills in planning, organizing, conflict resolution, negotiation and interpersonal skills to work with autonomy in meeting case management goals and initiatives
  • Demonstrated ability to work independently in accomplishing assignments, program goals and objectives

 


Physical & Mental Requirement:



  • Ability to properly drive and operate a company vehicle

   


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.

  • Case Manager

    2 weeks ago

    Dallas, Texas, United States Katie L. Lewis, P.C. Family Law Full time

    Job Title: Case ManagerThe Katie L. Lewis, P.C. Family Law team is seeking a highly skilled Case Manager to join our dynamic team. As a Case Manager, you will play a critical role in the intake process, ensuring that new clients are properly onboarded and set up for success.In this role, you will be responsible for:Evaluating prospective client inquiries and...

  • Professional Case Management | Registered Nurse

    4 days ago

    Dallas City, IL, United States Professional Case Management Full time

    Make a Difference on Your Own Schedule and Terms! Hiring Registered Nurses in Illinois Professional Case Management, the leader in home healthcare, is now hiring RN's to provide in-home healthcare services to help those who have served our country! Benefit from one-on-one patient relationships and from the satisfaction of enhancing clients' health,...

  • Case Manager

    2 weeks ago

    Dallas, United States Optum Full time

    WellMed, part of the Optum family of businesses, is seeking a Case Manager, LVN or LPN - WellMed at University to join our team in Dallas, TX. 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...

  • CASE MANAGER

    1 day ago

    Dallas, United States Abounding Prosperity Inc. Full time

    Job DescriptionJob DescriptionThe Case Manager will provide client-centered case management services to gay, bisexual, MSM (men who have sex with men), and male-to-female (MTF) transgender individuals who are at risk of or living with HIV/AIDS in Dallas County. The Case Manager assists clients with remaining connected to appropriate medical, behavioral...

  • Professional Case Management | Licensed Practical Nurse

    4 days ago

    Dallas City, IL, United States Professional Case Management Full time

    Make a Difference on Your Own Schedule and Terms! Hiring Licensed Practical Nurses in Illinois Professional Case Management, the leader in home healthcare, is now hiring LPN's/LVN's to provide in-home healthcare services to help those who have served our country! Benefit from one-on-one patient relationships and from the satisfaction of enhancing clients'...

  • Director Of Case Management

    3 days ago

    Dallas, United States RightWorks Inc Full time

    Top Client in need of Director Case ManagementJob Summary The Facility Case Management Director has the overall responsibility for managing and coordinating department activities. The Director ensures staff compliance with organizational policies and external regulatory agencies and takes leadership responsibility to coordinate the integration of the...

  • Case Management Professional

    3 weeks ago

    Dallas, Texas, United States IASIS Healthcare Full time

    **Job Description:**We are seeking a skilled Case Management Professional to join our team at Steward Health Care. As a Case Management Professional, you will play a vital role in ensuring that patients receive high-quality, cost-effective care.The ideal candidate will have a strong background in healthcare, with experience in case management and a passion...

  • Settlements Case Manager

    3 days ago

    Dallas, United States Witherite Law Group Full time

    Witherite Law Group (WLG) is a personal injury law firm specializing in motor vehicle accidents. Our vision is to improve the life of each person we serve. Whether it is for our employees, our clients, or our community, WLG puts people first, provides unmatched expertise, and displays integrity in every situation. Our attorneys and staff are committed to...

  • Medical Case Manager

    1 week ago

    Dallas, Texas, United States Incredible Health Full time

    About the RoleWe are seeking a skilled Medical Case Manager to join our team at Incredible Health in Dallas, TX.This is a rewarding opportunity for a professional with experience in case management to work closely with healthcare providers and patients to deliver exceptional care coordination.Key ResponsibilitiesConduct comprehensive assessments of patients,...

  • Case Management Specialist

    1 week ago

    Dallas, Texas, United States Abounding Prosperity Inc. Full time

    **Case Management Specialist**About Our OrganizationAt Abounding Prosperity Inc., we strive to provide high-quality healthcare services that cater to the unique needs of our clients. As a Case Management Specialist, you will play a crucial role in ensuring that our clients receive the best possible care.Job Description:We are seeking a skilled and empathetic...

  • Rn Case Manager

    1 week ago

    Dallas, United States Optum Full time

    WellMed, part of the Optum family of businesses, is seeking a RN Case Manager PHM to join our team in Texas. 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...

  • Law Firm Case Manager

    12 hours ago

    Dallas, United States Smith Clinesmith LLP Full time

    Our busy law office is growing, and we need a legal case manager to work alongside attorneys and achieve our clients’ goals. Our ideal candidate will have experience in case management as a paralegal or legal assistant and is skilled in drafting documents, managing case files, and conducting legal research. We need someone who is an effective communicator,...

  • IP Case Manager

    1 week ago

    Dallas, Texas, United States Wegman Full time

    Key ResponsibilitiesFiling electronically with the federal district courts, United States Patent and Trademark Office (USPTO), and International Trade Commission (ITC)Docketing deadlines and managing complex litigation casesConducting patent and trademark research, drafting pleadings, and locating case lawSupporting attorneys during IP litigation by...

  • Youth Case Manager

    16 hours ago

    Dallas, United States New Friends New Life Full time

    New Friends New Life restores and empowers formerly trafficked girls and sexually exploited women and children. By providing access to education, job training, interim financial assistance, mental health, and spiritual support, New Friends New Life helps women and children overcome backgrounds of abuse, addiction, poverty, and limited opportunities. **PLEASE...

  • Director of Case Management

    3 days ago

    Dallas, United States NurseRecruiter.com Full time

    Company Summary: Join our client, a leading organization in the healthcare industry, committed to delivering exceptional patient care through innovation and collaboration. With a clear mission to elevate healthcare standards and values rooted in integrity and compassion, our client strives to make a significant impact on the communities they serve. Overview...

  • NextSteps Case Manager

    3 days ago

    Dallas, United States Buckner International Full time

    Buckner Children and Family Services Community: NextStepsProgram Location: Dallas, TX - Onsite Address: 5310 S. Buckner Blvd Job Schedule: Full-Time We are seeking a NextSteps Case Manager to join our NextSteps Program. As a NextSteps Case Manager, you will Shine Hope as you are responsible for the coordination and provision of services to residents of...

  • Director of Case Management and Utilization Management

    13 hours ago

    Dallas, United States Scottish Rite for Children Full time

    Our patients are our number one priority! We're committed to giving children back their childhood! Job Posting Title: Director of Case Management and Utilization Management Location: Dallas - Hospital Additional Posting Details: Monday - Friday 8:00am to 4:30pm Job Description: Duties/Responsibilities: Utilization Management supporting medical...

  • Mass Tort Case Manager

    1 week ago

    Dallas, Texas, United States Top Talent Central Full time

    Job OverviewWe are seeking an experienced Mass Tort Case Manager to oversee the lifecycle of mass tort cases at Top Talent Central. The ideal candidate will have a strong background in plaintiffs mass torts and experience managing a team of paralegals and/or legal assistants.The successful candidate will collaborate with leadership to establish case...

  • Case Management Attorney Specialist

    1 month ago

    Dallas, Texas, United States Simon Greenstone Panatier, PC Full time

    Simon Greenstone Panatier, PC: A Leading Toxic Tort FirmAbout Us:We are a full-service toxic tort and pharmaceutical litigation firm with offices in Texas, New York, and California. Our practice areas include asbestos litigation, products liability, general pharmaceutical, opioid litigation, and catastrophic personal injury and wrongful death cases.The...

  • Case Management Coordinator

    2 weeks ago

    Dallas, Texas, United States KTC LAW FIRM Full time

    Job SummaryWe are a dynamic law firm seeking a talented litigation paralegal to contribute to our team's success.The ideal candidate will possess exceptional organizational skills, excellent communication abilities, and a keen attention to detail. This position offers a competitive salary of $70,000 - $90,000 per year.Main ResponsibilitiesSupport the...