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.
Keywords: UnitedHealth Group, Arcadia , RN, Care Manager - Arcadia, CA, Healthcare , Arcadia, California
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