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Nurse Care Coordinator for Complex Patients
2 weeks ago
Optum At Home Overview
We are creating a new model of care that addresses the physical, mental, and social needs of our patients. As part of this innovative approach, we are seeking a skilled Nurse Case Manager RN to join our Optum At Home team.
This role is ideal for a compassionate and resourceful nurse who can work collaboratively with interdisciplinary care teams to provide patient-centered care in various settings, including patient homes. Our Nurse Case Managers play a critical role in helping patients navigate the healthcare system, connect them to key support services, and promote health maintenance and disease prevention.
Key Responsibilities
- Care Coordination: Assess patient needs, develop and implement personalized plans of care, and ensure seamless transitions within and between healthcare settings.
- Patient Education: Provide counseling and education on health maintenance, disease prevention, condition trajectory, and follow-up recommendations.
- Community Resource Referrals: Identify and connect patients with necessary community resources, promoting self-sufficiency and optimal outcomes.
- Collaboration and Communication: Work closely with multidisciplinary teams, including Nurse Practitioners, Behavioral Health Advocates, Care Navigators, and other supporting members, to optimize clinical integration, efficiency, and effectiveness of care delivery.
- Documentation and Reporting: Maintain accurate and complete electronic medical records, ensuring timely and thorough documentation of patient interactions and interventions.
Required Qualifications
- Current unrestricted licensure as RN in WI
- 2+ years of relevant experience in assessing medical needs of patients with complex behavioral, social, and/or functional needs
- Demonstrated ability to work with diverse care teams in various settings, including non-clinical settings (primarily patient homes)
- Proven solid computer skills, including use of Electronic Medical Records
- Ability to travel 100% of the time in Madison, WI area for field-based work within 60 miles of residence
- Valid driver's license and access to reliable transportation
About Us
At Optum, we believe everyone deserves access to high-quality, patient-centered care. We're committed to mitigating our impact on the environment and delivering equitable care that addresses health disparities and improves health outcomes. Join our team and be part of something innovative and meaningful.