Registered Nurse Case Coordinator

1 week ago

Chippewa Falls, Wisconsin, United States Optum Full time
Company Overview:

Optum is a worldwide organization dedicated to enhancing healthcare through innovative technology, empowering millions to lead healthier lives.

The contributions you make with our team will significantly influence health outcomes by linking individuals with essential care, pharmacy benefits, data, and resources to support their well-being.

Here, you will discover a culture driven by diversity and inclusion, talented colleagues, comprehensive benefits, and opportunities for career advancement.

Make a meaningful impact on the communities we serve as you help us promote health equity on a global scale.

Position Summary:

The Registered Nurse Case Coordinator is responsible for overseeing patient services through a collaborative interdisciplinary approach, ensuring a clinical and psychosocial perspective throughout the care continuum.

Through ongoing case management, patients will be evaluated to assess the suitability of admission, continued hospitalization, and the appropriate level of care.

Case Coordinators ensure timely delivery of care at the right moment and in the right environment by adhering to established guidelines, addressing operational challenges, and collaborating with all relevant parties.

Discharge planning will commence at the time of (or prior to) admission and will be continuously reassessed throughout the hospitalization in collaboration with the clinical team, the patient, and/or the patient's representative.

Quality and Risk Management issues will also be monitored and reported as necessary.

Key Responsibilities:
  • Directs patient disposition and utilization considerations.
  • Assumes a leadership role to facilitate interdisciplinary collaboration.
  • Effectively resolves issues and actively seeks solutions.
  • Communicates directly with staff, physicians, patients, and families.
  • Models leadership behavior through professionalism, respect, and efficiency.
  • Coordinates patient care processes to achieve desired quality outcomes and identifies/controls inappropriate resource utilization.
  • Facilitates patient and family education to promote continuity of care and optimal patient outcomes.
  • Ensures patient rights by providing choices when appropriate.
  • Reviews the patient care plan with the multidisciplinary team.
  • Documents in the medical record and communicates verbally with the team to coordinate interventions and ensure continuity of care.
  • Maintains daily communication and collaboration with patient care staff for continuous assessment and planning.
  • Functions independently, utilizing time effectively and organizing assignments for maximum productivity.
  • Arranges schedules for meetings with physicians for patient care rounds and team discussions.
  • Utilizes established criteria to assess appropriate patient status.
  • Demonstrates proficiency in basic Microsoft Office applications.
  • Remains adaptable to meet the hospital's needs, which may include supporting other departments as patient needs change.
  • Develops care plans for patients frequently utilizing emergency services in collaboration with the patient's physician and community resources.
  • Maintains knowledge of applicable federal and state regulations.
  • Reports relevant information to the department director regarding length of stay and financial matters affecting the continuum of care process.
Qualifications:

Required:

  • Associate's Degree (or higher) in Nursing.
  • Current, unrestricted RN license in the state of employment.
  • 1+ years of experience with knowledge of community resources, policies, and procedures.
  • 1+ years of clinical experience with knowledge of various age groups, including but not limited to the unborn child through geriatric age groups.

Preferred:

  • Bachelor of Science in Nursing.
  • 2+ years of case management experience.
  • Case Management Certification.
  • Strong analytical, critical thinking, and organizational skills.
  • Experience with established assessment criteria.
  • Knowledge of Utilization Review and Medicare requirements, as well as relevant state and federal regulations.

At Optum, our mission is to help individuals lead healthier lives and improve the healthcare system for everyone. We believe that everyone deserves the opportunity to achieve their healthiest life, regardless of race, gender, sexuality, age, location, or income.

We are committed to addressing health disparities and enhancing health outcomes through equitable care, which is a core priority reflected in our mission.

Diversity Commitment:

Optum is an Equal Employment Opportunity / Affirmative Action employer. 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.

Optum maintains a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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