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Registered Nurse Case Manager, Flexible Schedule
2 months ago
Optum Home & Community Care, a segment of the UnitedHealth Group family, is pioneering a transformative approach in health care. We are integrating top-tier solutions to develop a comprehensive care model that thoroughly addresses an individual's physical, mental, and social requirements, facilitating patient access and navigation of care at any time and in any location.
As a vital member of our Senior Community Care (SCC) initiative, we collaborate to deliver care to patients in their residences, including nursing homes and assisted living facilities for seniors. This impactful role enhances support to improve care accessibility, connecting services to create a cohesive health journey for patients across various care environments.
In the capacity of a Long-term Care Optum Registered Nurse, you will operate as an integral part of the primary care team, reporting directly to the Clinical Services Manager (CSM). This position necessitates close collaboration with all interdisciplinary team members and may involve supporting multiple providers. Face-to-face interactions with members in nursing home settings are essential. The RN Case Manager is a versatile team member who operates under the guidance of the Advanced Practice Clinician (APC), with activities delegated by the Senior Case Manager or the CSM.
Schedule: This is a Per Diem/Casual role requiring a minimum of 24 hours per month during standard business hours, with optional weekend availability.
Primary Responsibilities:
- Assist the provider/team with various care coordination tasks within the nursing home.
- Support the provider/team with benefit determinations related to Medicare Part A, Part B, and Part D.
- Collaborate with the primary APC and nursing facility to identify and address patient changes in condition.
- May assist the provider by completing DSTs, re-assessing patients, and performing other delegated activities.
- Facilitate therapy coordination for members, including potential assessments or follow-ups on requests, while communicating with the APC.
- Conduct interval check-ins on patient progress with the therapy department.
- Participate in facility-based therapy discussion meetings.
- Schedule and engage in family conferences, team meetings, and case presentations.
- Assist in coordinating training, tracking, and compliance with quality measures.
- Participate in facility partnership or Customer Relationship Management (CRM) meetings under the direction of the APC/CSM.
- May assist in organizing CRM meetings and contribute to discussions.
- Support the team in tracking LearnSource completion for team members and the CSM.
- Assist in creating and conducting in-services for targeted audiences.
- Document information and activities in the EMR.
- Support providers in ensuring complete and accurate documentation, coding, medication reconciliation, nursing rounds, assessments, and patient documentation.
- Assist the team/providers in prioritizing advance care planning and initiating discussions.
- Collaborate with key stakeholders, providers, nursing homes, PCPs, families, interdisciplinary care teams, and other identified parties.
- Review charts and enter HEDIS/Quality information into the EMR, communicating gaps to the provider.
- May write verbal orders from the provider in compliance with state RN practice laws and individual nursing facility practices.
You'll be recognized for your contributions in an environment that challenges you while providing clear direction for success in your role and opportunities for development in other areas of interest.
Required Qualifications:
- Current, unrestricted RN license in North Carolina.
- Valid Driver's License with reliable transportation.
- 1+ years of experience using an Electronic Medical Record.
- Ability to be present in nursing facilities 100% of the time.
Preferred Qualifications:
- 1+ years of experience in post-acute care, such as long-term care or critical care.
- 1+ years of experience working with the geriatric population.
- Demonstrated ability to collaborate with diverse care teams across various settings.
- Proven effective communication and time management skills.
At UnitedHealth Group, our mission is to assist individuals in leading healthier lives and improving the health system for everyone. We believe that everyone, regardless of race, gender, sexuality, age, location, or income, deserves the opportunity to live their healthiest life. However, numerous barriers to good health persist, disproportionately affecting people of color, historically marginalized groups, and those with lower incomes. We are dedicated to minimizing our environmental impact and delivering equitable care that addresses health disparities and enhances health outcomes, reflecting our mission.
Diversity fosters a healthier environment: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer, 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.
UnitedHealth Group maintains a drug-free workplace. Candidates are required to pass a drug test prior to commencing employment.