RN, Care Manager - Arcadia, CA

Company: UnitedHealth Group
Location: Arcadia
Posted on: January 12, 2023

Job Description:

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing -your life's best work.(sm) -Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work.(sm) -Optum's Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California, to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions. -Responsible for providing professional nursing care by assessing, planning, implementing and evaluating the care of patients under the supervision of a clinician or RN, Supervisor, or RN Charge Nurse. Delegates tasks as needed to professionals and para-professional employees. Coordinates activities and works closely with clinicians and staff to maintain efficient department functions and ensure successful operation of the department. Responsible for performing operational duties as required under the supervision of the site administrator or designee. Familiar with Model of Care and NCQA guidelines -Primary Responsibilities: -

• Prioritizes patient care needs upon initial visit and addresses emerging issues
• Meets with telephonically with patients, patients' family and caregivers as needed to discuss care and treatment plan
• Identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings
• Consults with physician and other team members to ensure that care plan is successfully implemented
• Uses protocols and pathways in line with established disease management and care management programs in order to optimize clinical outcomes and minimize unnecessary institutional care
• Monitors and coaches patients using techniques of motivational interviewing and behavioral change to maximize self-management
• Oversees provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc. in order to maintain continuity of care
• Works in coordination with the care team and demonstrates accountability with patient management and outcome
• Discusses Durable Power of Attorney (DPOA) and advanced directive status with patient and PCP when applicable
• Maintains effective communication with the physicians, hospitalists, extended care facilities, patients and families
• Provides accurate information to patients and families regarding resources available to them through health plan benefits, community resources, and referrals
• Participates actively in Monthly Care Management Department meetings and daily huddles
• Documents pertinent patient information and Care Management Plan in Electronic Health Record
• Coordinates care with central departments on assigned patient caseload, including, inpatient, long term care facilities, adult family homes, and home health agencies
• Demonstrates a thorough understanding of the cost consequences resulting from Care Management decisions through utilization reports and systems such as Health Plan Benefits, CM dashboards and reports
• Maintains concise and accurate documentation that supports effective and efficient management of care plans to decrease Emergency and hospital readmissions
• Adheres to departmental policies and procedures. Uses, protects, and discloses HCP patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Participates in training all new care managersYou'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. -Required Qualifications: -
  • Graduation from an accredited school of nursing
  • Active, unrestricted Registered Nurse license through the State of California
  • -1+ years of experience in a clinical setting or care management
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodationPreferred Qualification: -
    • Bachelor of Science in Nursing, BSN -
    • Specialty certifications in CCMC -
    • 5+ years of previous care management, utilization review or discharge planning experience -
    • 3+ years of experience working in acute care -To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employmentCareers with Optum. -Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do -your life's best work.(sm)Diversity creates a healthier atmosphere: 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 is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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