Case Manager RN Specialist

4 weeks ago

Thornton, Colorado, United States Optum Full time
Optum Case Manager RN Job Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. 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.

Job Summary

The Case Manager RN is responsible and accountable for coordination of patient services through an interdisciplinary process, which provides a clinical and psychosocial approach through the continuum of care. Through concurrent case management, patients will be assessed to determine appropriateness of admission, continued hospitalization, as well as appropriate level of care.

Discharge planning will begin at the time of (or prior to) admission, and reassessed ongoing throughout the course of hospitalization. Quality and Risk Management issues will also be monitored for and reported as appropriate.

Responsibilities
  • Directly communicates with staff, physicians, patients and families
  • Coordinates patient care processes to achieve desired quality outcomes and identifies/controls inappropriate resource utilization
  • Facilitates patient and family education and promotes continuity of care to achieve optimal patient outcomes. Assures patient rights by offering a choice when appropriate
  • Reviews the patient plan of care with the multi-disciplinary team. Facilitates and participates in multi-disciplinary team care conferences for patients with complex problems. Communicates in the medical record and verbally with the team to coordinate interventions and facilitate continuity of care
  • Daily communication and collaboration with the patient care staff to provide continuous assessment, evaluation and continuum planning to assure the patient receives the appropriate level of care at the appropriate time.
  • Facilitates the implementation of nursing interventions as indicated by the multi-disciplinary team plan of care that enhances and compliments the skill level of the nursing staff
  • Functions without direct supervision, utilizing time constructively and organizing assignments for maximum productivity. Arranges schedule to facilitate meeting with physicians for patient care rounds, team meetings and other opportunities to improve communication
  • An initial assessment is required to be completed for all inpatients within 36 hours of admission (Per employee average caseload of 12 patients per day)
  • Excess Days per Patient discharge should remain under 1.39 days per contract requirements
  • A discharge summary is required for all patient discharges
Requirements
  • Associate's Degree (or higher)
  • Valid unrestricted RN License in the state of Colorado OR Master of Social Work (MSW) Degree
  • Ability to commit to working 1 weekend day per pay period (1 weekend day every 2 weeks)
Preferred Qualifications
  • Bachelor of Science in Nursing (BSN)
  • Case Management Certification
  • 3+ years of recent clinical or case management experience in area of specialization
  • Knowledge/understanding of community resources, policies, and procedures
Soft Skills
  • Solid analytical, critical thinking and organizational skills

No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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