RN Care Coordinator
1 week ago
M-F No nights, weekends or on-call
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.
An RN functions as part of the primary care team, and reports to the Clinical Services Manager (CSM). The supports the APC and our members to coordinate care services. This role works in close collaboration with all of the team members, and may support multiple providers. The RN works under the direction of the provider, and activities are delegated to the RN by the provider or the team CSM. The RN understands and supports the CPM models of care Institutional Special Needs Plan (ISNP), Institutional Special Needs Plan (IESNP) and Transitions to Skilled (TTS) and works in collaboration with the team to meet the goals of the program. This role will support our members telephonically and in- person in patient settings and home settings.
Primary Responsibilities:
- Establishes and maintains communication and a trusting collaborative relationship with the ICT, member/RP and primary caregiver staff in the ALC and APC
- Communicates with multiple organizations operational units for seamless coordination of benefits, i.e., utilization review staff, provider relations liaison, pharmacy, etc.
- Reviews member's status and assists to achieve progress toward goals; adjusts the ICP as necessary
- Performs administrative functions for or on behalf of the PCP and/or APC
- Participates in program effectiveness analysis and planning
- Performs member visits and rounding as established and directed by the APC
- Communicates status of member with APC for evaluation and ICP updates
- Communicates with member, family/RP, primary caregivers of the community and other members of the ICT with each member visit
- Assists with other clinical and quality responsibilities for member, e.g., gaps in care
- Attends meetings on behalf of the APC and communicates updates to the ICP with the ICT
- Provides clinical educational programs for facility staff
- Communicates information on behalf of the APC to the member, family/RP and primary caregiver staff at the ALC
- Coordinates and collaborates with the health plan/client
- Assists with ACP
- Performs collection of data including functional status, BMI, vital signs, urine test for proteinuria, IFOBT specimen collection, and other clinical data. Results are entered into EMR and reviewed by APC
- Performs care coordination activities within the ALC to ensure member needs are met. (i.e., member external provider appointments, therapy needs, durable medical equipment (DME) and transportation)
- Stays abreast of all Model of Care (MOC) , documentation and policy updates communicated email, newsletters and team meetings
- Maintains an understanding of and utilizes clinical resources independently including but not limited to Resource1, iCoreCodeGenius, Sparq, Learnsource and other Optum internal sites
- Maintains confidential health information according to state and federal regulations including HIPAA
Required Qualifications:
- Current unrestricted Registered Nurse license in Oregon
- 3+ years of RN experience
- 1+ years of case management experience
- Experience with using an electronic medical records
- Demonstrated basic Microsoft Office skills with the ability to navigate in a Window's environment
- Proven excellent communication and customer service skills
- Valid driver's license and the ability to travel locally 75% of the time
- BSN
- Experience working in post- acute care, such as long term care or hospice and/or Case Management experience as an RN
- Experience working with the geriatric population
- Familiarity with the long-term care business environment
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.
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