Registered Nurse Case Manager jobs at Tenet Healthcare - 181 jobs
TRA RN and Allied specialties Travel and Local Contracts
Tenet Healthcare 4.5
Registered nurse case manager job at Tenet Healthcare
This is a general application which is applicable across all TRA locations and, all RN and Allied Travel and Local contracts. When you receive your offer letter, it will be customized for the specific position you are hired into.
With TRA, you will receive greater contract security than with outside agencies while accessing exciting travel and local contracts across the nation.
Why Choose TRA?
Guaranteed Hours for Travel Contracts
Preferred Booking Agreement for Local Contracts
Company Matching funds for the 401K
Holiday Pay
TRA is preferred for all contract assignments within Tenet while receiving the same tenure as Tenet staff.
Location: This is a general application link and, you can be hired into any specific position that fits with what location you are looking to be hired into. As mentioned above, your offer letter will be customized and specific for the position you and your Recruiter speak about.
$107k-134k yearly est. Auto-Apply 60d+ ago
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RN DRG Coding Auditor - Remote
Tenet Healthcare Corporation 4.5
Registered nurse case manager job at Tenet Healthcare
The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted.
The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends and patterns to the CRC leadership. Provides expert application of evidence based medical necessity review criteria tool. Works collaboratively to review, evaluate and improve the denial appeal process.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
* Formulates and submits letters of appeal. Creates an effective appeal utilizing relevant and effective clinical documentation from the medical record; supported by current industry clinical guidelines and coding guidelines, evidence-based medicine, community and national medical management and coding standards and protocols.
* Performs reviews of accounts denied for DRG validation and DRG downgrades.
* Documents in appropriate denial tracking tool (ACE). Maintains and distributes reports as needed to leadership.
* Identifies payment methodology of accounts including Managed Care contract rates, Medicare and State Funded rates, Per-Diems, DRG's, Outlier Payments, and Stop Loss calculations.
* Collaborates with Physician Advisors and CRC leadership when documentation-specific areas of concern are identified.
* Maintains expertise in clinical areas and current trends in healthcare, inpatient coding and reimbursement methodologies and utilization management specialty areas.
KNOWLEDGE, SKILLS, ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
* Effectively organizes work priorities
* Demonstrates compliance with departmental safety and security policies and practices
* Demonstrates critical thinking, analytical skills, and ability to resolve problems
* Demonstrates ability to handle multiple assignments and carry out work independently with minimal supervision
* Demonstrates quality proficiency by maintaining accuracy at unit standard key performance indicator goals
* Possesses excellent written and verbal communication skills
* Detail oriented and ability to work independently and in a team setting
* Moderate skills in MS Excel and PowerPoint, MS Office
* Ability to research difficult coding and documentation issues and follow through to resolution
* Ability to work in a virtual setting under minimal supervision
* Ability to conduct research regarding state/federal guidelines and applicable regulatory guidelines related to government audit processes
Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.
EDUCATION / EXPERIENCE
Includes minimum education, technical training, and/or experience required to perform the job.
Education
* Minimum Required:
* Completion of BSN Degree Program or three years of experience and completion of BSN within five years of employment
* RN License in the State of Practice
* Current working knowledge of clinical documentation and inpatient coding, discharge planning, utilization management, casemanagement, performance improvement and managed care reimbursement.
* Preferred/Desired:
* Completion of BSN Degree Program
* CCDS certification or inpatient coding certification
Experience
* Minimum Required:
* Three to Five years Clinical RN Experience
* Three to Five years of Clinical Documentation Integrity experience
* Must have expertise with Interqual and/or MCG Disease Management Ideologies
* Strong communication (verbal/written) and interpersonal skills
* Knowledge of CMS regulations
* Knowledge of inpatient coding guidelines
* 1-2 years of current experience with reimbursement methodologies
* Preferred/Desired:
* Experience preparing appeals for clinical denials related to DRG assignment.
* Strong understanding of rules and guidelines, including AHA's Coding Clinics, American Association of Medical Audit Specialists (AAMAS), National Commission on Insurance Guidelines and Medicare Billing Guidelines (CMS), State Funded Billing Regulations (Arizona, California, Nevada) and grievance process; working knowledge of billing codes such as RBRVS, CPT, ICD-10, HCPCS
CERTIFICATES, LICENSES, REGISTRATIONS
* Required:
* RN,
* CCDS or other related clinical documentation specialist certification, and/or AHIMA or AAPC Coding Credential CCS, CCA, CIC, CPC or CPMA
* Preferred: BSN
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
* Ability to lift 15-30lbs
* Ability to travel approximately 10% of the time; either to client sites, National Insurance Center (NIC) sites, Headquarters, or other designated sites
* Ability to sit and work at a computer for a prolonged period of time conducting medical record quality reviews
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
* Characteristic of typical office environment requiring use of desk, chair, and office equipment such as computer, telephone, printer, etc.
OTHER
* Interaction with facility HIM and / or physician advisors
* Must meet the requirements of the Conifer Telecommuting Policy and Procedure
As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
Compensation and Benefit Information
Compensation
* Pay: $56,784.00 - $85,176.00 annually. Compensation depends on location, qualifications, and experience.
* Management level positions may be eligible for sign-on and relocation bonuses.
Benefits
Conifer offers the following benefits, subject to employment status:
* Medical, dental, vision, disability, life, and business travel insurance
* Paid time off (vacation & sick leave) - min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked.
* 401k with up to 6% employer match
* 10 paid holidays per year
* Health savings accounts, healthcare & dependent flexible spending accounts
* Employee Assistance program, Employee discount program
* Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
* For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.
Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Tenet participates in the E-Verify program. Follow the link below for additional information.
E-Verify: *****************************
The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations.
**********
$56.8k-85.2k yearly 60d+ ago
PRN Registered Nurse - RN
Universal Health Services 4.4
Mansfield, OH jobs
Responsibilities
Foundations for Living is seeking a dedicated and compassionate RN - RegisteredNurse to join our team and provide vital support on alternate weekends. Our organization operates as a residential treatment facility, catering to at-risk youth in need of specialized care and support. The primary responsibility of this role will be to bolster our existing nursing team during the critical hours of 6:00 AM to 6:00 PM on every other weekend. As an RN at Foundations for Living, you will play a crucial role in ensuring the well-being and health of our youth residents, contributing to their positive growth and development. This position offers a unique opportunity to make a meaningful difference in the lives of young individuals while working within a supportive and caring team environment.
Responsibilities:
Administer medications as prescribed and monitor their effects
Conduct health assessments and document observations accurately
Collaborate with the treatment team to develop and implement individualized care plans
Monitor and assist residents with daily living activities, ensuring their safety and well-being
Provide emotional support and crisis intervention as needed
Maintain accurate and up-to-date medical records and documentation
Communicate effectively with the treatment team, residents, and their families
Participate in staff meetings, trainings, and continuing education opportunities
Qualifications:
Current RN license in Ohio
Experience working in a mental health setting, preferably with adolescents
Strong understanding of psychiatric nursing principles and practices
Excellent communication and interpersonal skills
Ability to remain calm and composed in challenging situations
Demonstrated ability to work collaboratively as part of a multidisciplinary team
Basic computer skills for documentation purposes
Compassion, empathy, and a genuine interest in working with mental health teens
Salary: $25.00 - $36.00 per hour
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. An individual must be able to perform their duties in a positive work mode and serve as a positive role model and influence for clients and peers. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
* Graduate of an accredited School of Nursing and at least 2 years experience in the nursing field preferred. Experience in mental health field preferred but not required.
Certifications, Licenses, Registrations
Valid State RegisteredNursing License
Valid State Drivers License with appropriate endorsements
Certified in CPR and First Aid
Language Skills
* Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.. Ability to teach groups about medical management of medications and other health issues.
Mathematical Skills
* Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent.
Reasoning Ability
* Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Physical Demands
* While performing the duties of this job, the employee is regularly required to stand; walk; sit; use hands to finger, handle, or feel; reach with hands and arms; climb or balance; stoop, kneel, crouch, or crawl; and talk or hear. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close, distant, and peripheral vision, color and depth perception, and ability to adjust focus.
Therapeutic Hold
* The employee may occasionally be required to physically restrain clients, using authorized hold procedures as a last resort for protection of resident and staff
Work Environment
* While performing the duties of this job, the employee is occasionally exposed to outside weather conditions. The employee is occasionally exposed to blood-borne pathogens and infectious diseases. The noise level in the work environment is usually moderate. Minimal local travel is required as deemed by supervisor. While performing the duties of this job, the employee may be exposed to clients who may ask inappropriate personal questions, display socially unacceptable personal behaviors, use profanity and sexually explicit phrases, make insulting remarks or threats regarding appearance, age, sex, or race, exhibit defiance, dishonesty, and assaultive or self-destructive behaviors.
$25-36 hourly 8d ago
NP or PA, Home Based Medical Care Statewide Traveler - AR
Unitedhealth Group 4.6
Little Rock, AR jobs
**$40,000 Student Loan Repayment Or $25,000 Sign-on Bonus for Individuals Who Have Not Previously Participated in this Program**
Optum is seeking a NP or PA - Home Based Medical Care Statewide Traveler to join our team in Little Rock, AR. Optum is a clinician-led care organization, that is creating a seamless health journey for patients across the care continuum.
As a member of the broader Home and Community Care team, you'll provide annual clinical assessments to patients in the comfort of their homes. This important preventive care helps identify and reduce health risks for patients, in addition to coordinating appropriate follow-up care to improve health and well-being.
At Optum, the integrated medical teams who practice within Home and Community Care are creating something new in health care. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while **Caring. Connecting. Growing together.**
Positions in these functions works as a provider member within the HBMC interdisciplinary team in the direct delivery of home-based medical care of a population within an assigned geography. Dedicated to improving the health and well-being of patients, this position collaborates with the PCP, HBMC interdisciplinary teammates and consultants, and as needed, the health plan Medical Director and other health professionals, to develop and carry out patients' goals of care in all phases of the patient journey.
**Primary Responsibilities:**
+ Performs an initial comprehensive assessment of all newly enrolled patients and provides ongoing care thereafter
+ Develops a patient management care plan upon enrollment and updates it as needed when changes in condition warrant or following hospitalization
+ Meets with patients and/or their legal representatives to review newly developed or modified care plans; involves the PCP or supervising physician in these meetings, when applicable
+ Comfortable with basic procedures of nursing care, including IV placement, blood draws, injections, foley catheters, nasal packing, wound care, etc. New hire and annual skills check/training provided
+ Prescribes appropriate diagnostics and interventions to avoid unnecessary acute admissions
+ Completes follow-up and post-discharge assessments according to documented standard operating procedure
+ Consults with hospital, emergency or post-acute clinical team following notification of patient transfer
+ Educates patients and/or their legal representatives in disease processes affecting patients and ways to manage them effectively, as well as to promote wellness
+ Actively participates in ongoing meetings pertaining to patient care and clinical excellence
+ Implements HEDIS measure campaigns and other quality initiatives to ensure the highest standards of care and to promote the improvement of care management and delivery
+ Keeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews
+ Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing or physician assistants
You'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:**
+ Completion of Nurse Practitioner or Physician Assistant accredited program
+ Current state RN/NP or PA license or ability to obtain by start date
+ Certification through the American Academy of Nurse Practitioners (AANP), American Nurses Credentialing Center (ANCC), or National Commission on Certification of Physician Assistants (NCCPA), or the ability to obtain national certification and/or NP license in state of assignment by start date
+ Current active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice)
+ Access to reliable transportation; if you are driving a vehicle, you must comply with all the terms of the Optum Motor Vehicle Safety policy
**Preferred Qualifications:**
+ 2+ years of clinical NP experience in IM, Geriatrics, Primary Care, ED, Urgent Care, Home Health Care visits or similar setting
+ Proven excellent administrative and organizational skills and the ability to effectively communicate with seniors and their families
+ Proven computer literate and able to navigate the internet
****PLEASE NOTE**** Employees must be in an active regular status. Employees must remain in role for a minimum of 12 months from the date of hire /rehire/transfer. If an employee leaves Home and Community, the student loan repayments will cease. **The employee must remain in an Advanced Practice Clinician or Physician role within Home and Community for 36 months to receive the full benefit of the student loan repayments.**
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. 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 employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
$48k-60k yearly est. 8d ago
NP Home Based Medical Care Cumberland, Sampson, Bladen Counties, NC
Unitedhealth Group 4.6
Clinton, NC jobs
**$40,000 Student Loan Repayment Or $20,000 Sign-on Bonus for Individuals Who Have Not Previously Participated in this Program**
**Optum is seeking a Home Based Medical Care Nurse Practitioner to join our team in Cumberland, Sampson, and Bladen Counties, NC. Optum is a clinician-led care organization, that is creating a seamless health journey for patients across the care continuum.**
**As a member of the broader Home and Community Care team, you'll provide annual clinical assessments to patients in the comfort of their homes. This important preventive care helps identify and reduce health risks for patients, in addition to coordinating appropriate follow-up care to improve health and well-being.**
At Optum, the integrated medical teams who practice within Home and Community Care are creating something new in health care. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while **Caring. Connecting. Growing together.**
Position in these functions works as a provider member within the HBMC interdisciplinary team in the direct delivery of home-based medical care of a population within an assigned geography. Dedicated to improving the health and well-being of patients, this position collaborates with the PCP, HBMC interdisciplinary teammates and consultants, and as needed, the health plan Medical Director and other health professionals, to develop and carry out patients' goals of care in all phases of the patient journey.
**Primary Responsibilities:**
+ Performs an initial comprehensive assessment of all newly enrolled patients and provides ongoing care thereafter
+ Develops a patient management care plan upon enrollment and updates it as needed when changes in condition warrant or following hospitalization
+ Meets with patients and/or their legal representatives to review newly developed or modified care plans; involves the PCP or supervising physician in these meetings, when applicable
+ Comfortable with basic procedures of nursing care, including IV placement, blood draws, injections, foley catheters, nasal packing, wound care, etc. New hire and annual skills check/training provided
+ Prescribes appropriate diagnostics and interventions to avoid unnecessary acute admissions
+ Completes follow-up and post-discharge assessments according to documented standard operating procedure
+ Consults with hospital, emergency or post-acute clinical team following notification of patient transfer
+ Educates patients and/or their legal representatives in disease processes affecting patients and ways to manage them effectively, as well as to promote wellness
+ Actively participates in ongoing meetings pertaining to patient care and clinical excellence
+ Implements HEDIS measure campaigns and other quality initiatives to ensure the highest standards of care and to promote the improvement of care management and delivery
+ Keeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews
+ Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing or physician assistants
You'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:**
+ Current state RN/NP license or ability to obtain by start date
+ Certification through the American Academy of Nurse Practitioners (AANP), or the American Nurses Credentialing Center (ANCC)
+ Current active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice)
+ Driver's license and access to reliable transportation; if you are driving a vehicle, you must comply with all the terms of the Optum Motor Vehicle Safety policy
**Preferred Qualifications:**
+ 2+ years of clinical NP experience in IM, Geriatrics, Primary Care, ED, Urgent Care, Home Health Care visits or similar setting
+ Proven excellent administrative and organizational skills and the ability to effectively communicate with seniors and their families
+ Proven computer literate and able to navigate the internet
Compensation for this specialty generally ranges from $104,500 - $156,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. 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 employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
$41k-52k yearly est. 3d ago
NP Home Based Medical Care Cumberland, Sampson, Bladen Counties, NC
Unitedhealth Group Inc. 4.6
Fayetteville, NC jobs
$40,000 Student Loan Repayment Or $20,000 Sign-on Bonus for Individuals Who Have Not Previously Participated in this Program
Optum is seeking a Home Based Medical Care Nurse Practitioner to join our team in Cumberland, Sampson, and Bladen Counties, NC. Optum is a clinician-led care organization, that is creating a seamless health journey for patients across the care continuum.
As a member of the broader Home and Community Care team, you'll provide annual clinical assessments to patients in the comfort of their homes. This important preventive care helps identify and reduce health risks for patients, in addition to coordinating appropriate follow-up care to improve health and well-being.
At Optum, the integrated medical teams who practice within Home and Community Care are creating something new in health care. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while Caring. Connecting. Growing together.
Position in these functions works as a provider member within the HBMC interdisciplinary team in the direct delivery of home-based medical care of a population within an assigned geography. Dedicated to improving the health and well-being of patients, this position collaborates with the PCP, HBMC interdisciplinary teammates and consultants, and as needed, the health plan Medical Director and other health professionals, to develop and carry out patients' goals of care in all phases of the patient journey.
Primary Responsibilities:
Performs an initial comprehensive assessment of all newly enrolled patients and provides ongoing care thereafter
Develops a patient management care plan upon enrollment and updates it as needed when changes in condition warrant or following hospitalization
Meets with patients and/or their legal representatives to review newly developed or modified care plans; involves the PCP or supervising physician in these meetings, when applicable
Comfortable with basic procedures of nursing care, including IV placement, blood draws, injections, foley catheters, nasal packing, wound care, etc. New hire and annual skills check/training provided
Prescribes appropriate diagnostics and interventions to avoid unnecessary acute admissions
Completes follow-up and post-discharge assessments according to documented standard operating procedure
Consults with hospital, emergency or post-acute clinical team following notification of patient transfer
Educates patients and/or their legal representatives in disease processes affecting patients and ways to manage them effectively, as well as to promote wellness
Actively participates in ongoing meetings pertaining to patient care and clinical excellence
Implements HEDIS measure campaigns and other quality initiatives to ensure the highest standards of care and to promote the improvement of care management and delivery
Keeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews
Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing or physician assistants
You'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:
Current state RN/NP license or ability to obtain by start date
Certification through the American Academy of Nurse Practitioners (AANP), or the American Nurses Credentialing Center (ANCC)
Current active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice)
Driver's license and access to reliable transportation; if you are driving a vehicle, you must comply with all the terms of the Optum Motor Vehicle Safety policy
Preferred Qualifications:
2+ years of clinical NP experience in IM, Geriatrics, Primary Care, ED, Urgent Care, Home Health Care visits or similar setting
Proven excellent administrative and organizational skills and the ability to effectively communicate with seniors and their families
Proven computer literate and able to navigate the internet
Compensation for this specialty generally ranges from $104,500 - $156,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. 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 employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
$41k-52k yearly est. 8d ago
NP Home Based Medical Care Cumberland, Sampson, Bladen Counties, NC
Unitedhealth Group 4.6
Fayetteville, NC jobs
**$40,000 Student Loan Repayment Or $20,000 Sign-on Bonus for Individuals Who Have Not Previously Participated in this Program**
**Optum is seeking a Home Based Medical Care Nurse Practitioner to join our team in Cumberland, Sampson, and Bladen Counties, NC. Optum is a clinician-led care organization, that is creating a seamless health journey for patients across the care continuum.**
**As a member of the broader Home and Community Care team, you'll provide annual clinical assessments to patients in the comfort of their homes. This important preventive care helps identify and reduce health risks for patients, in addition to coordinating appropriate follow-up care to improve health and well-being.**
At Optum, the integrated medical teams who practice within Home and Community Care are creating something new in health care. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while **Caring. Connecting. Growing together.**
Position in these functions works as a provider member within the HBMC interdisciplinary team in the direct delivery of home-based medical care of a population within an assigned geography. Dedicated to improving the health and well-being of patients, this position collaborates with the PCP, HBMC interdisciplinary teammates and consultants, and as needed, the health plan Medical Director and other health professionals, to develop and carry out patients' goals of care in all phases of the patient journey.
**Primary Responsibilities:**
+ Performs an initial comprehensive assessment of all newly enrolled patients and provides ongoing care thereafter
+ Develops a patient management care plan upon enrollment and updates it as needed when changes in condition warrant or following hospitalization
+ Meets with patients and/or their legal representatives to review newly developed or modified care plans; involves the PCP or supervising physician in these meetings, when applicable
+ Comfortable with basic procedures of nursing care, including IV placement, blood draws, injections, foley catheters, nasal packing, wound care, etc. New hire and annual skills check/training provided
+ Prescribes appropriate diagnostics and interventions to avoid unnecessary acute admissions
+ Completes follow-up and post-discharge assessments according to documented standard operating procedure
+ Consults with hospital, emergency or post-acute clinical team following notification of patient transfer
+ Educates patients and/or their legal representatives in disease processes affecting patients and ways to manage them effectively, as well as to promote wellness
+ Actively participates in ongoing meetings pertaining to patient care and clinical excellence
+ Implements HEDIS measure campaigns and other quality initiatives to ensure the highest standards of care and to promote the improvement of care management and delivery
+ Keeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews
+ Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing or physician assistants
You'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:**
+ Current state RN/NP license or ability to obtain by start date
+ Certification through the American Academy of Nurse Practitioners (AANP), or the American Nurses Credentialing Center (ANCC)
+ Current active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice)
+ Driver's license and access to reliable transportation; if you are driving a vehicle, you must comply with all the terms of the Optum Motor Vehicle Safety policy
**Preferred Qualifications:**
+ 2+ years of clinical NP experience in IM, Geriatrics, Primary Care, ED, Urgent Care, Home Health Care visits or similar setting
+ Proven excellent administrative and organizational skills and the ability to effectively communicate with seniors and their families
+ Proven computer literate and able to navigate the internet
Compensation for this specialty generally ranges from $104,500 - $156,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. 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 employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
$41k-52k yearly est. 3d ago
NP Home Based Medical Care Cumberland, Sampson, Bladen Counties, NC
Unitedhealth Group 4.6
Elizabethtown, NC jobs
**$40,000 Student Loan Repayment Or $20,000 Sign-on Bonus for Individuals Who Have Not Previously Participated in this Program**
**Optum is seeking a Home Based Medical Care Nurse Practitioner to join our team in Cumberland, Sampson, and Bladen Counties, NC. Optum is a clinician-led care organization, that is creating a seamless health journey for patients across the care continuum.**
**As a member of the broader Home and Community Care team, you'll provide annual clinical assessments to patients in the comfort of their homes. This important preventive care helps identify and reduce health risks for patients, in addition to coordinating appropriate follow-up care to improve health and well-being.**
At Optum, the integrated medical teams who practice within Home and Community Care are creating something new in health care. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while **Caring. Connecting. Growing together.**
Position in these functions works as a provider member within the HBMC interdisciplinary team in the direct delivery of home-based medical care of a population within an assigned geography. Dedicated to improving the health and well-being of patients, this position collaborates with the PCP, HBMC interdisciplinary teammates and consultants, and as needed, the health plan Medical Director and other health professionals, to develop and carry out patients' goals of care in all phases of the patient journey.
**Primary Responsibilities:**
+ Performs an initial comprehensive assessment of all newly enrolled patients and provides ongoing care thereafter
+ Develops a patient management care plan upon enrollment and updates it as needed when changes in condition warrant or following hospitalization
+ Meets with patients and/or their legal representatives to review newly developed or modified care plans; involves the PCP or supervising physician in these meetings, when applicable
+ Comfortable with basic procedures of nursing care, including IV placement, blood draws, injections, foley catheters, nasal packing, wound care, etc. New hire and annual skills check/training provided
+ Prescribes appropriate diagnostics and interventions to avoid unnecessary acute admissions
+ Completes follow-up and post-discharge assessments according to documented standard operating procedure
+ Consults with hospital, emergency or post-acute clinical team following notification of patient transfer
+ Educates patients and/or their legal representatives in disease processes affecting patients and ways to manage them effectively, as well as to promote wellness
+ Actively participates in ongoing meetings pertaining to patient care and clinical excellence
+ Implements HEDIS measure campaigns and other quality initiatives to ensure the highest standards of care and to promote the improvement of care management and delivery
+ Keeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews
+ Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing or physician assistants
You'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:**
+ Current state RN/NP license or ability to obtain by start date
+ Certification through the American Academy of Nurse Practitioners (AANP), or the American Nurses Credentialing Center (ANCC)
+ Current active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice)
+ Driver's license and access to reliable transportation; if you are driving a vehicle, you must comply with all the terms of the Optum Motor Vehicle Safety policy
**Preferred Qualifications:**
+ 2+ years of clinical NP experience in IM, Geriatrics, Primary Care, ED, Urgent Care, Home Health Care visits or similar setting
+ Proven excellent administrative and organizational skills and the ability to effectively communicate with seniors and their families
+ Proven computer literate and able to navigate the internet
Compensation for this specialty generally ranges from $104,500 - $156,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. 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 employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
$41k-52k yearly est. 3d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare 4.4
Delaware, OH jobs
For this position we are seeking a (RN) RegisteredNurse who must live and have a current active unrestricted RN license in the state of OHCaseManager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important.
Home office with internet connectivity of high speed required.
Schedule: Monday thru Friday 8:00AM to 5:00PM
Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (ColumbusOH). (Mileage is reimbursed)
JOB DESCRIPTION Job Summary
Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments.
• Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• May provide consultation, resources and recommendations to peers as needed.
• Care manager RNs may be assigned complex member cases and medication regimens.
• Care manager RNs may conduct medication reconciliation as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).
Required Qualifications
• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• RegisteredNurse (RN). License must be active and unrestricted in state of practice.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA).
• Demonstrated knowledge of community resources.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to work independently, with minimal supervision and self-motivation.
• Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving, and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
Preferred Qualifications
• Certified CaseManager (CCM).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$26.4-51.5 hourly 2d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare 4.4
Beavercreek, OH jobs
For this position we are seeking a (RN) RegisteredNurse who must live and have a current active unrestricted RN license in the state of OHCaseManager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important.
Home office with internet connectivity of high speed required.
Schedule: Monday thru Friday 8:00AM to 5:00PM
Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (ColumbusOH). (Mileage is reimbursed)
JOB DESCRIPTION Job Summary
Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments.
• Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• May provide consultation, resources and recommendations to peers as needed.
• Care manager RNs may be assigned complex member cases and medication regimens.
• Care manager RNs may conduct medication reconciliation as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).
Required Qualifications
• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• RegisteredNurse (RN). License must be active and unrestricted in state of practice.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA).
• Demonstrated knowledge of community resources.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to work independently, with minimal supervision and self-motivation.
• Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving, and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
Preferred Qualifications
• Certified CaseManager (CCM).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$26.4-51.5 hourly 2d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare 4.4
Cleveland, OH jobs
For this position we are seeking a (RN) RegisteredNurse who must live and have a current active unrestricted RN license in the state of OHCaseManager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important.
Home office with internet connectivity of high speed required.
Schedule: Monday thru Friday 8:00AM to 5:00PM
Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (ColumbusOH). (Mileage is reimbursed)
JOB DESCRIPTION Job Summary
Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments.
• Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• May provide consultation, resources and recommendations to peers as needed.
• Care manager RNs may be assigned complex member cases and medication regimens.
• Care manager RNs may conduct medication reconciliation as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).
Required Qualifications
• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• RegisteredNurse (RN). License must be active and unrestricted in state of practice.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA).
• Demonstrated knowledge of community resources.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to work independently, with minimal supervision and self-motivation.
• Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving, and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
Preferred Qualifications
• Certified CaseManager (CCM).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$26.4-51.5 hourly 2d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare 4.4
Cincinnati, OH jobs
For this position we are seeking a (RN) RegisteredNurse who must live and have a current active unrestricted RN license in the state of OHCaseManager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important.
Home office with internet connectivity of high speed required.
Schedule: Monday thru Friday 8:00AM to 5:00PM
Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (ColumbusOH). (Mileage is reimbursed)
JOB DESCRIPTION Job Summary
Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments.
• Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• May provide consultation, resources and recommendations to peers as needed.
• Care manager RNs may be assigned complex member cases and medication regimens.
• Care manager RNs may conduct medication reconciliation as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).
Required Qualifications
• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• RegisteredNurse (RN). License must be active and unrestricted in state of practice.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA).
• Demonstrated knowledge of community resources.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to work independently, with minimal supervision and self-motivation.
• Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving, and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
Preferred Qualifications
• Certified CaseManager (CCM).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$26.4-51.5 hourly 2d ago
Telephonic RN Case Manager - Remote
Unitedhealth Group 4.6
Richardson, TX jobs
Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.**
We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone CaseManager RN with Optum, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today!
**Must be available to work within business hours Monday through Friday with 2 days a week until 8PM CST.**
**Primary Responsibilities:**
+ Make outbound calls and receive inbound calls to assess members' current health status
+ Make referrals to outside sources
+ Identify gaps or barriers in treatment plans
+ Provide patient education to assist with self-management
+ Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction
+ Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels
+ Works with less structured, more complex issues
+ Serves as a resource for others
This is high volume, customer service environment. You'll need to be efficient, productive and thoroughly dealing with our members over the phone. solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Current, unrestricted RN license in the state of residence
+ Ability to obtain additional state licensure as needed by the business
+ 3+ years of experience in a hospital, acute care or direct care setting
+ Ability to work 2 nights per week until 8PM CST
+ Ability to navigate a Windows Based Environment
+ Access to high-speed internet and a designated, distraction free workplace
**Preferred Qualifications:**
+ BSN
+ Certified CaseManager (CCM)
+ Casemanagement experience
+ Experience or exposure to discharge planning
+ Experience in discharge planning or utilization review
+ Experience in a telephonic role
+ Background in managed care
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. 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._
_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._
$60.2k-107.4k yearly 1d ago
Registered Nurse Case Manager Hospice - PRN
Unitedhealth Group Inc. 4.6
Columbus, OH jobs
Explore opportunities with Caretenders Hospice, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.
As the RegisteredNurseCaseManager, you will assume full nursing responsibility for the delivery of the Plan of Care for each hospice patient. Continuously evaluating personal and professional performance and making necessary changes to increase productivity and quality of care delivered. You'll also develop the patient's Plan of care in collaboration with other professionals and implement treatment strategies based on scientific nursing theory that promotes physical, psychosocial, emotional, and spiritual well-being. Familiar with the concepts and needs of patients/families who are facing death and dying.
Primary Responsibilities:
* Makes the initial nursing evaluation in determining eligibility for hospice services during visit within forty-eight (48) hours of referral
* Identifies the patient's/family's physical, psychosocial, and environmental needs and re-assesses as needed, no less than every fifteen (15) days
* Initiates and coordinates the plan of care
* Documents problems, appropriate goals, interventions, and patient/family response to hospice care
* Collaborates with the patient/family, attending physician and other members of the IDG in providing patient and family care daily
* Instructs and supervises the patient/family in self-care techniques when appropriate
* Maintains accurate and relevant clinical notes regarding the patient's condition
You'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:
* Current and unrestricted RN licensure in the state of practice
* 1+ years of clinical experience
* Current CPR Certification
* Current driver's license, valid vehicle insurance, and access to a dependable vehicle, or public transportation
* Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client
Preferred Qualifications:
* Able to work independently
* Good communication, writing, and organizational skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. 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 employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$58.8k-105k yearly 13d ago
Field Nurse Case Manager - Grove City, OH
Unitedhealth Group 4.6
Columbus, OH jobs
Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere.
As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home.
We're connecting care to create a seamless health journey for patients across care settings. Join us to start **Caring. Connecting. Growing together.**
RegisteredNurses in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home visits, telephonic outreach and consultations, and interdisciplinary team activities.
The Field CaseManager RN may perform care and counsel of the ill, injured, or infirm, in the promotion and maintenance of health with individuals, groups, or both throughout the life span. They help to manage health problems and coordinate health care for the Optum at Home patients in accordance with State and Federal rules and regulations and the nursing standards of care. This includes (but is not limited to) assessment of health status, development and implementation of plan of care, and ongoing evaluation of patient status and response to the plan of care. Clinical management is conducted in collaboration with other care team members.
**Primary Responsibilities:**
+ Reports to RN Manager
+ Assess the health status of members as within the scope of licensure and with the frequency established in the model of care
+ Establish goals to meet identified health care needs
+ Plan, implement and evaluate responses to the plan of care
+ Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care
+ Works closely with mental health clinicians to help bridge the gap between mental and physical health
+ Consult with the patient's PCP, specialists, or other health care professionals as appropriate
+ Assess patient needs for community resources and make appropriate referrals for service
+ Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians
+ Completely and accurately document in patient's electronic medical record
+ Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit
+ Verify and document patient and/or family understanding of condition, plan of care and follow up recommendations
+ Actively participate in organizational quality initiatives
+ Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery
+ Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs
+ Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation and relationships in the care provided to our member
You'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.
Years of post-high school education can be substituted/is equivalent to years of experience.
**Required Qualifications:**
+ Current unrestricted licensure as RN in Ohio
+ 2+ years of relevant experience
+ Experience in assessing the medical needs of patients with complex behavioral, social and/or functional needs
+ Demonstrated ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes)
+ Proven solid computer skills, including use of electronic medical records
+ Ability to travel 100% of the time for field-based work within 60 miles of residence
+ Valid driver's license
+ Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
**Preferred Qualification:**
+ Field based experience
+ Casemanagement experience
+ Proven effective time management and communication skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
_OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
$58.8k-105k yearly 19d ago
Field Case Manager RN - Cincinnati OH
Unitedhealth Group Inc. 4.6
Cincinnati, OH jobs
Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere.
As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home.
We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.
RegisteredNurses in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home visits, telephonic outreach and consultations, and interdisciplinary team activities.
The Field CaseManager RN may perform care and counsel of the ill, injured, or infirm, in the promotion and maintenance of health with individuals, groups, or both throughout the life span. They help to manage health problems and coordinate health care for the Optum at Home patients in accordance with State and Federal rules and regulations and the nursing standards of care. This includes (but is not limited to) assessment of health status, development and implementation of plan of care, and ongoing evaluation of patient status and response to the plan of care. Clinical management is conducted in collaboration with other care team members.
Primary Responsibilities:
* Reports to RN Manager
* Assess the health status of members as within the scope of licensure and with the frequency established in the model of care
* Establish goals to meet identified health care needs
* Plan, implement and evaluate responses to the plan of care
* Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care
* Works closely with mental health clinicians to help bridge the gap between mental and physical health
* Consult with the patient's PCP, specialists, or other health care professionals as appropriate
* Assess patient needs for community resources and make appropriate referrals for service
* Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians
* Completely and accurately document in patient's electronic medical record
* Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit
* Verify and document patient and/or family understanding of condition, plan of care and follow up recommendations
* Actively participate in organizational quality initiatives
* Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery
* Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs
* Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation and relationships in the care provided to our member
You'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.
Years of post-high school education can be substituted/is equivalent to years of experience.
Required Qualifications:
* Current unrestricted licensure as RN in Ohio
* 2+ years of relevant experience
* Experience in assessing the medical needs of patients with complex behavioral, social and/or functional needs
* Demonstrated ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes)
* Proven solid computer skills, including use of electronic medical records
* Ability to travel 100% of the time for field-based work within 60 miles of residence
* Valid driver's license
* Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
Preferred Qualification:
* Field based experience
* Casemanagement experience
* Proven effective time management and communication skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
$60.2k-107.4k yearly 4d ago
Field Case Manager RN - Cincinnati OH
Unitedhealth Group 4.6
Cincinnati, OH jobs
Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere.
As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home.
We're connecting care to create a seamless health journey for patients across care settings. Join us to start **Caring. Connecting. Growing together.**
RegisteredNurses in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home visits, telephonic outreach and consultations, and interdisciplinary team activities.
The Field CaseManager RN may perform care and counsel of the ill, injured, or infirm, in the promotion and maintenance of health with individuals, groups, or both throughout the life span. They help to manage health problems and coordinate health care for the Optum at Home patients in accordance with State and Federal rules and regulations and the nursing standards of care. This includes (but is not limited to) assessment of health status, development and implementation of plan of care, and ongoing evaluation of patient status and response to the plan of care. Clinical management is conducted in collaboration with other care team members.
**Primary Responsibilities:**
+ Reports to RN Manager
+ Assess the health status of members as within the scope of licensure and with the frequency established in the model of care
+ Establish goals to meet identified health care needs
+ Plan, implement and evaluate responses to the plan of care
+ Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care
+ Works closely with mental health clinicians to help bridge the gap between mental and physical health
+ Consult with the patient's PCP, specialists, or other health care professionals as appropriate
+ Assess patient needs for community resources and make appropriate referrals for service
+ Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians
+ Completely and accurately document in patient's electronic medical record
+ Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit
+ Verify and document patient and/or family understanding of condition, plan of care and follow up recommendations
+ Actively participate in organizational quality initiatives
+ Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery
+ Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs
+ Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation and relationships in the care provided to our member
You'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.
Years of post-high school education can be substituted/is equivalent to years of experience.
**Required Qualifications:**
+ Current unrestricted licensure as RN in Ohio
+ 2+ years of relevant experience
+ Experience in assessing the medical needs of patients with complex behavioral, social and/or functional needs
+ Demonstrated ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes)
+ Proven solid computer skills, including use of electronic medical records
+ Ability to travel 100% of the time for field-based work within 60 miles of residence
+ Valid driver's license
+ Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
**Preferred Qualification:**
+ Field based experience
+ Casemanagement experience
+ Proven effective time management and communication skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
_OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
$60.2k-107.4k yearly 4d ago
Field Nurse Case Manager - Grove City, OH
Unitedhealth Group 4.6
Grove City, OH jobs
Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere.
As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home.
We're connecting care to create a seamless health journey for patients across care settings. Join us to start **Caring. Connecting. Growing together.**
RegisteredNurses in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home visits, telephonic outreach and consultations, and interdisciplinary team activities.
The Field CaseManager RN may perform care and counsel of the ill, injured, or infirm, in the promotion and maintenance of health with individuals, groups, or both throughout the life span. They help to manage health problems and coordinate health care for the Optum at Home patients in accordance with State and Federal rules and regulations and the nursing standards of care. This includes (but is not limited to) assessment of health status, development and implementation of plan of care, and ongoing evaluation of patient status and response to the plan of care. Clinical management is conducted in collaboration with other care team members.
**Primary Responsibilities:**
+ Reports to RN Manager
+ Assess the health status of members as within the scope of licensure and with the frequency established in the model of care
+ Establish goals to meet identified health care needs
+ Plan, implement and evaluate responses to the plan of care
+ Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care
+ Works closely with mental health clinicians to help bridge the gap between mental and physical health
+ Consult with the patient's PCP, specialists, or other health care professionals as appropriate
+ Assess patient needs for community resources and make appropriate referrals for service
+ Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians
+ Completely and accurately document in patient's electronic medical record
+ Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit
+ Verify and document patient and/or family understanding of condition, plan of care and follow up recommendations
+ Actively participate in organizational quality initiatives
+ Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery
+ Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs
+ Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation and relationships in the care provided to our member
You'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.
Years of post-high school education can be substituted/is equivalent to years of experience.
**Required Qualifications:**
+ Current unrestricted licensure as RN in Ohio
+ 2+ years of relevant experience
+ Experience in assessing the medical needs of patients with complex behavioral, social and/or functional needs
+ Demonstrated ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes)
+ Proven solid computer skills, including use of electronic medical records
+ Ability to travel 100% of the time for field-based work within 60 miles of residence
+ Valid driver's license
+ Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
**Preferred Qualification:**
+ Field based experience
+ Casemanagement experience
+ Proven effective time management and communication skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
_OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
$58.8k-105k yearly 50d ago
Field Nurse Case Manager - Grove City, OH
Unitedhealth Group Inc. 4.6
Grove City, OH jobs
Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere.
As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home.
We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.
RegisteredNurses in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home visits, telephonic outreach and consultations, and interdisciplinary team activities.
The Field CaseManager RN may perform care and counsel of the ill, injured, or infirm, in the promotion and maintenance of health with individuals, groups, or both throughout the life span. They help to manage health problems and coordinate health care for the Optum at Home patients in accordance with State and Federal rules and regulations and the nursing standards of care. This includes (but is not limited to) assessment of health status, development and implementation of plan of care, and ongoing evaluation of patient status and response to the plan of care. Clinical management is conducted in collaboration with other care team members.
Primary Responsibilities:
* Reports to RN Manager
* Assess the health status of members as within the scope of licensure and with the frequency established in the model of care
* Establish goals to meet identified health care needs
* Plan, implement and evaluate responses to the plan of care
* Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care
* Works closely with mental health clinicians to help bridge the gap between mental and physical health
* Consult with the patient's PCP, specialists, or other health care professionals as appropriate
* Assess patient needs for community resources and make appropriate referrals for service
* Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians
* Completely and accurately document in patient's electronic medical record
* Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit
* Verify and document patient and/or family understanding of condition, plan of care and follow up recommendations
* Actively participate in organizational quality initiatives
* Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery
* Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs
* Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation and relationships in the care provided to our member
You'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.
Years of post-high school education can be substituted/is equivalent to years of experience.
Required Qualifications:
* Current unrestricted licensure as RN in Ohio
* 2+ years of relevant experience
* Experience in assessing the medical needs of patients with complex behavioral, social and/or functional needs
* Demonstrated ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes)
* Proven solid computer skills, including use of electronic medical records
* Ability to travel 100% of the time for field-based work within 60 miles of residence
* Valid driver's license
* Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
Preferred Qualification:
* Field based experience
* Casemanagement experience
* Proven effective time management and communication skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
$58.8k-105k yearly 35d ago
Registered Nurse Case Manager Hospice - PRN
Unitedhealth Group 4.6
Moraine, OH jobs
Explore opportunities with Caretenders Hospice, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.**
**\#LHCJobs**
As the RegisteredNurseCaseManager, you will assume full nursing responsibility for the delivery of the Plan of Care for each hospice patient. Continuously evaluating personal and professional performance and making necessary changes to increase productivity and quality of care delivered. You'll also develop the patient's Plan of care in collaboration with other professionals and implement treatment strategies based on scientific nursing theory that promotes physical, psychosocial, emotional, and spiritual well-being. Familiar with the concepts and needs of patients/families who are facing death and dying.
**Primary Responsibilities:**
+ Makes the initial nursing evaluation in determining eligibility for hospice services during visit within forty-eight (48) hours of referral
+ Identifies the patient's/family's physical, psychosocial, and environmental needs and re-assesses as needed, no less than every fifteen (15) days
+ Initiates and coordinates the plan of care
+ Documents problems, appropriate goals, interventions, and patient/family response to hospice care
+ Collaborates with the patient/family, attending physician and other members of the IDG in providing patient and family care daily
+ Instructs and supervises the patient/family in self-care techniques when appropriate
+ Maintains accurate and relevant clinical notes regarding the patient's condition You'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:**
+ Current and unrestricted RN licensure in the state of practice
+ 1+ years of clinical experience
+ Current CPR Certification
+ Current driver's license, valid vehicle insurance, and access to a dependable vehicle, or public transportation
+ Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client
**Preferred Qualifications:**
+ Able to work independently
+ Good communication, writing, and organizational skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. 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 employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._