RN Field Case Manager

4 days ago

Manitowoc, United States Optum Full time

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.

The Senior Community Care (SCC) Senior Living program is a longitudinal, integrated care delivery program that coordinates the delivery and provision of clinical care of members residing in the Senior Community Setting (home, facility, apartments, etc.). The Senior Living RN within SCC provides care to our high risk health plan members and is part of an interdisciplinary team. In this role you will have the ability to achieve work life balance. Flexible scheduling offered where providers can flex their time over the 7-day work week. No on-call work is required. Individuals in the per diem role are expected to communicate their availability to their manager and be available 24 hours per month. Visits will primarly fall during evenings, weekends, and holidays when indicated. Optum is transforming care delivery with innovative and personal care.

Primary Responsibilities:

  • Ensure accurate and complete documentation
  • Communicate and collaborate with the interdisciplinary care team
  • Assist the provider / team with various care coordination activities
  • Assist the provider / team with benefit determination associated with Medicare part A, part B, and part D benefits
  • Responsible for collaborating with the primary advanced practice clinician, (APC), Care Navigator (CN), and Responsible Party (RP) to identify and respond to patient change in condition
  • Assist the provider / team with therapy coordination
  • Schedule and participate in family conferences, team meetings, and team case presentations
  • Coordination of training, tracking, and compliance with quality measures
  • Assist in creating and conducting in-services for selected audiences
  • Assist Providers in assuring complete and accurate documentation and coding, medication reconciliation, nursing rounds, assessment, and patient documentation.
  • Assist in managing members through an acute medical situation or an exacerbation of a chronic condition, including testing, diagnostics, interventions
  • Minimum hours worked 24 hours monthly with a maximum of up to 80 hours per month

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:

  • Associates degree or higher in Nursing (RN)
  • Active and unrestricted license in the state which you reside, or ability to obtain by start date
  • Compact Licensure or willingness to obtain within 90 days of start date
  • Certified in Basic Life Support
  • Ability to complete physical requirements, including lifting a 30-pound bag and ability to perform physical assessment
  • Access to reliable transportation

Preferred Qualifications:

  • 1+ years of clinical experience in a geriatric or elder care setting
  • Experience in meeting the medical needs of patients with complex behavioral, social and/or functional needs
  • Proven understanding of Geriatrics and Chronic Illness
  • Proficient computer skills including the ability to document medical information with written and electronic medical records
  • Ability to work with diverse care teams in a variety of settings
  • Effective communication skills and time management

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.

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