RN Quality and Medical Staff Services Manager

4 weeks ago


Manitowoc, Wisconsin, United States Optum Full time
Job Summary

As a Long-term Care and Assisted Living Optum Registered Nurse, you will function as part of the primary care team, reporting to the Clinical Services Manager (CSM). This role involves collaborating with the primary Advanced Practice Clinician, (APC) and nursing facility to identify and respond to patient Change in Condition.

Key Responsibilities
  • Assist the provider/team with various care coordination activities in the nursing home
  • Assist the provider/team with benefit determination associated with Medicare part A, part B, and part D benefits
  • Responsible for collaborating with the primary APC and nursing facility to identify and respond to patient Change in Condition
  • Assist the provider/team with therapy coordination for members, including possible assessments or follow-up on requests and communicate and collaborate with APC
  • May perform interval check-ins on patient progress with the therapy department
  • May participate in facility-based therapy discussion meetings
  • May assist in the coordination of training, tracking, and compliance with quality measures
  • May participate in the onboarding of new clinical staff under the direction of the CSM Manager, which could include coordination of onboarding activities and participation in other orientation activities
  • Participate in facility partnership or Customer Relationship Management (CRM) meetings under the direction of the APC/CSM
  • May assist in coordinating CRM meetings and may participate in and contribute to the meetings
  • Will document information and activities in the EMR
  • May assist providers in assuring complete and accurate documentation and coding, medication reconciliation, nursing rounds, assessment, and patient documentation
  • Assist the team/providers in prioritizing advance Care Planning and initiating discussions
  • Collaborates with all key stakeholders, providers, nursing homes, PCPs, families, interdisciplinary care teams, and any other identified stakeholders
  • Review the chart and enter HEDIS/Quality information into the Electronic Medical Record (EMR), communicate gaps to the Provider
  • May write verbal orders from Provider in the chart in compliance with the state RN practice laws and in compliance with individual nursing facility practices
  • Conducting goals of care conversations
What We Offer

We offer a competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. You'll also enjoy:

  • Paid Time Off, which you start to accrue with your first pay period, plus 8 Paid Holidays
  • Medical Plan options, along with participation in a Health Spending Account or a Health Saving account
  • Dental, Vision, Life & AD&D Insurance, along with Short-term disability and Long-Term Disability coverage
  • 401(k) Savings Plan, Employee Stock Purchase Plan
  • Education Reimbursement
  • Employee Assistance Program
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
Requirements

To be successful in this role, you'll need:

  • Associate degree or higher in Nursing (RN)
  • Valid Driver's License with access to reliable transportation that will enable you to travel up to 100% to visit clients and/or patient sites within a designated area
  • Bachelor's degree
  • 1+ years of experience in post-acute care, such as long-term care
  • 1+ years of experience with using an Electronic Medical Records
  • Familiarity with Medicare part A, part B, and part D benefits
  • Familiarity with the long-term care business environment
  • Basic Microsoft Office skills with the ability to navigate in a Windows environment
  • Proven ability to work with diverse care teams in a variety of settings
About Us

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. 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.

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.


  • Staff Nurse RN HFM

    1 month ago


    Manitowoc, Wisconsin, United States Froedtert Hospital Full time

    Job SummaryWe are seeking a skilled and compassionate Staff Nurse RN to join our team at Froedtert Hospital. As a Staff Nurse RN, you will play a vital role in providing high-quality patient care and contributing to the success of our healthcare team.ResponsibilitiesPlan, organize, and coordinate direct nursing care for an identified group of patients...

  • Staff Nurse

    4 weeks ago


    Manitowoc, Wisconsin, United States Froedtert Hospital Full time

    Job Summary:As a Staff Nurse at Froedtert Health, you will be responsible for providing direct nursing care to patients in a fast-paced medical environment. With a focus on patient-centered care, you will work collaboratively with a multidisciplinary team to deliver high-quality care and achieve exceptional patient outcomes.Responsibilities:• Provide...

  • Staff Nurse RN HFM

    4 weeks ago


    Manitowoc, Wisconsin, United States Froedtert Health Full time

    Job Summary:As a Staff Nurse RN HFM at Froedtert Health, you will plan, organize, coordinate, and provide direct nursing care for an identified group of patients according to specific standards. This role requires at least one year of experience in Med/Surg, with a preference for experience in ER, and/or CCU nursing. ACLS certification is required within the...


  • Manitowoc, Wisconsin, United States Froedtert Health Full time

    Job Summary: We are seeking a skilled Registered Nurse to join our team at Froedtert Health. As a Clinic RN, you will be responsible for providing high-quality patient care in a fast-paced outpatient setting. Your expertise will be essential in addressing the wellness, acute illness, chronic disease, disability, and end-of-life needs of our patients. You...

  • Nurse - Staff RN

    4 weeks ago


    Manitowoc, Wisconsin, United States Froedtert Hospital Full time

    Job Summary:As a Staff Registered Nurse at Froedtert Health, you will play a vital role in delivering high-quality patient care. We are seeking a skilled and compassionate nurse to join our team and contribute to the well-being of our patients.Responsibilities: Plan, organize, and coordinate direct nursing care for an identified group of patients according...

  • Staff Nurse RN HFM

    4 weeks ago


    Manitowoc, Wisconsin, United States Froedtert Hospital Full time

    Job Summary:We are seeking a skilled Staff Nurse RN HFM to join our team. The ideal candidate will have at least one year of experience in Med/Surg and be able to provide direct nursing care for an identified group of patients according to specific standards.Responsibilities:Plans, organizes, coordinates and provides direct nursing care for an identified...

  • Staff Nurse

    4 weeks ago


    Manitowoc, Wisconsin, United States Froedtert Health Full time

    Job Summary:We are seeking a skilled and compassionate Registered Nurse to join our Emergency Department team at Froedtert Health. As a Staff Nurse, you will be responsible for providing high-quality patient care, collaborating with interdisciplinary teams, and contributing to a positive and supportive work environment.Key Responsibilities:Provide direct...

  • Staff Pharmacist FT

    4 weeks ago


    Manitowoc, Wisconsin, United States CVS Health Full time

    At CVS Health, we're committed to delivering enhanced human-centric healthcare for a rapidly changing world. As a Staff Pharmacist, you'll play a critical role in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient, and affordable.Our purpose is to bring our heart to every...

  • Staff Pharmacist FT

    4 weeks ago


    Manitowoc, Wisconsin, United States CVS Health Full time

    At CVS Health, we're committed to delivering enhanced human-centric healthcare for a rapidly changing world. As a Staff Pharmacist, you'll play a critical role in supporting the management, oversight, and operation of all aspects within your pharmacy.Key Responsibilities:Patient SafetyPharmacy Professional PracticeRegulatory RequirementsQuality...

  • RN Case Manager

    4 weeks ago


    Manitowoc, Wisconsin, United States Optum Full time

    Unlock a Rewarding Career in Long-term CareOptum is seeking a dedicated and compassionate Registered Nurse (RN) to join our Senior Community Care team. As an RN Case Manager, you will play a vital role in providing high-quality care to patients in their homes, nursing facilities, and assisted living communities.Key Responsibilities:Collaborate with...


  • Manitowoc, Wisconsin, United States Froedtert Hospital Full time

    Job Summary:As a Registered Nurse at Froedtert Holy Family Memorial, you will provide direct nursing care to patients in a fast-paced environment. With a focus on patient-centered care, you will work collaboratively with the healthcare team to deliver high-quality care and achieve excellent patient outcomes.Responsibilities:Plan, organize, and coordinate...


  • Manitowoc, Wisconsin, United States Oak Medical Full time

    Job Summary: Oak Medical is seeking an experienced Advanced Practice Provider (NP/PA) to deliver high-quality, onsite medical care in skilled nursing facilities. This role is focused on providing both acute and chronic care management for adult and geriatric patients. The APP will work collaboratively with supervising physicians to develop and implement...


  • Manitowoc, Wisconsin, United States BayCare Clinic Full time

    About BayCare ClinicBayCare Clinic is a dynamic group of healthcare professionals dedicated to providing measurably superior specialty medical services to our patients. Our mission is to deliver high-quality care with compassion, professionalism, and a commitment to excellence.The RoleWe are seeking a Licensed Practical Nurse (LPN) to join our team at...

  • RN Case Manager

    4 weeks ago


    Manitowoc, Wisconsin, United States UnitedHealth Group Full time

    OverviewUnitedHealth Group is seeking a highly skilled RN Case Manager to join our Senior Community Care team. As a vital member of our team, you will be responsible for coordinating care for patients in long-term care settings, ensuring they receive the best possible support to manage their health conditions.Key ResponsibilitiesAssist providers and...


  • Manitowoc, Wisconsin, United States ARBY'S - 7561 Full time

    Job Summary:As a Shift Manager at ARBY'S - 7561, you will be responsible for overseeing the daily operations of our restaurant. This includes supervising staff, managing inventory, and ensuring exceptional customer service.Key Responsibilities:Train and develop staff members to meet high standards of quality and service.Supervise and participate in kitchen...

  • Nurse Practitioner

    4 weeks ago


    Manitowoc, Wisconsin, United States Matrix Medical Network Full time

    OverviewMatrix Medical Network is seeking a skilled Nurse Practitioner to join our teamAs a Nurse Practitioner with Matrix Medical Network, you will have the opportunity to make a meaningful impact on the health and well-being of our patients.We are looking for a highly motivated and compassionate individual who is passionate about delivering high-quality...


  • Manitowoc, Wisconsin, United States Forefront Dermatology Full time

    Job Title: Medical Records ClerkJob Description:Job Summary:The Medical Records Clerk is responsible for the overall management, storage, and retrieval of medical records. This role requires a high level of organization, attention to detail, and excellent communication skills.Key Responsibilities:Coordinate and process requests for the release of medical...

  • Medical Director

    1 month ago


    Manitowoc, Wisconsin, United States Froedtert & the Medical College of Wisconsin Full time

    We are seeking a highly skilled and experienced Hospitalist to join our team at Froedtert Holy Family Memorial Medical Center in Manitowoc, WI. As a Hospitalist, you will be responsible for providing high-quality patient care, collaborating with our multidisciplinary team, and contributing to the development of our hospital's clinical programs.Key...


  • Manitowoc, Wisconsin, United States Forefront Dermatology Full time

    At Forefront Dermatology, we are seeking a highly skilled Medical Records Specialist to join our team in our Manitowoc, WI office. As a Medical Records Specialist, you will be responsible for the overall management, storage, and retrieval of medical records, ensuring accuracy and compliance with regulations and standards.Job SummaryThis is a full-time...

  • RN Case Manager

    1 month ago


    Manitowoc, Wisconsin, United States UnitedHealth Group Full time

    Job SummaryAs a Registered Nurse Case Manager with Optum Home & Community Care, you will play a vital role in providing high-quality care to patients in their homes and skilled nursing facilities. You will work closely with our interdisciplinary team to coordinate care, ensure seamless transitions, and promote patient-centered outcomes.Key Responsibilities*...