Clinical Case Manager RN
1 week ago
At Optum, we strive to deliver care and improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to live healthier lives. As a Case Manager RN, you will play a critical role in our mission by coordinating patient services through an interdisciplinary process, providing a clinical and psychosocial approach throughout the continuum of care.
The Case Manager RN is responsible for assessing patients to determine the appropriateness of admission, continued hospitalization, and the appropriate level of care. Discharge planning begins at the time of admission, and ongoing assessments are conducted throughout the hospitalization. Quality and Risk Management issues are monitored and reported as necessary.
Key Responsibilities:
- Directly communicate with staff, physicians, patients, and families to ensure seamless care coordination.
- Coordinate patient care processes to achieve desired quality outcomes and identify/controls inappropriate resource utilization.
- Facilitate patient and family education, promoting continuity of care to achieve optimal patient outcomes.
- Review the patient plan of care with the multi-disciplinary team, facilitating and participating in care conferences for patients with complex problems.
- Daily communication and collaboration with patient care staff to provide continuous assessment, evaluation, and continuum planning to ensure patients receive the appropriate level of care at the appropriate time.
- Function independently, utilizing time constructively and organizing assignments for maximum productivity.
Requirements:
- Associate's Degree (or higher) or Master of Social Work (MSW) Degree.
- Valid unrestricted RN License in the state of Colorado.
- Ability to commit to working 1 weekend day per pay period.
Preferred Qualifications:
- Bachelor of Science in Nursing (BSN) Degree.
- Case Management Certification.
- 3+ years of recent clinical or case management experience in the area of specialization.
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