Registered Nurse, Care Manager
Location: West Covina
Posted on: April 28, 2021
Do you have compassion and a passion to help
others?--Transforming healthcare and millions of lives as a result
starts with the values you embrace and the passion you bring to
achieve--your life's best work.(sm)What You'll Do (aka
Description):Responsible for ensuring the continuity of care in the
outpatient setting utilizing the appropriate resources within the
parameters of established contracts and patients' health plan
benefits.-- Facilitates continuum of patients' care utilizing
advanced nursing knowledge, experience and skills to ensure
appropriate utilization of resources and patient quality
outcomes.-- Performs care management functions telephonically.
Ensures all care management activities are efficient, effective and
meet regulatory requirements. Reports finding to the department
management team in a timely manner.What Work Will Look Like:
- Consistently exhibits behavior and communication skills that
demonstrate Optum's commitment to superior customer service,
including quality, care and concern with each and every internal
and external customer.
- Implements and monitors current medical group care management
programs within the policies and procedures set by the
- Reviews patient referrals within the specified care management
policy timeframe per Ambulatory Care Management Program
- Identifies and assists with the follow-up of selected patient
population in ambulatory settings.
- Consults with physician and other team members to ensure that
care plan is successfully implemented.
- Maintains effective communication with the health plans,
physicians, hospitals, extended care facilities, patients and
- Provides accurate information to patients and families
regarding HMO benefits, community resources, referrals and other
- Initiates and oversees data entry into IS systems of all
patients within the parameters of care management policies and
- Maintains timely, accurate and complete documentation of care
- Follows patients on ambulatory care management programs
- Maintains accuracy of list and program enrollment per
established guidelines and playbook
- Engages with appropriate members of the organization in a
professional, effective way.
- Demonstrates accountability and ownership of patient population
- Seeks and identifies opportunities for process
- Meets or exceeds productivity targets.
- Uses, protects, and discloses Optum patients' protected health
information (PHI) only in accordance with Health Insurance
Portability and Accountability Act (HIPAA) standards.
- Performs additional duties as assigned.What's required?
- Graduate from an accredited school of Nursing.
- Current California RN license.
- Bachelor's degree in Nursing preferred.
- Basic Life Support for Healthcare providers (AHA) or CPR/AED
for the Professional Rescuer (American Red Cross).
- Computer literate.
- Ability to work with multiple computer platforms
- Knowledge of current standards of patient care.
- Thorough understanding of RN scope of practice.
- Manual dexterity to use and handle equipment and
- Ability to effectively communicate and collaborate with
physicians, patients, families and ancillary staff.
- Ability to make sound, independent judgments and act
professionally under pressure.
- Demonstrates effective documentation and verbal communication
skills: factual, accurate, clear and timely to support delivery of
effective patient care interventions and collaborative
management.If you need to enter a work site for any reason, you
will be required to screen for symptoms using the ProtectWell
mobile app, Interactive Voice Response (i.e., entering your
symptoms via phone system) or a similar UnitedHealth Group-approved
symptom screener. Employees must comply with any state and local
masking orders. In addition, when in a UnitedHealth Group building,
employees are expected to wear a mask in areas where physical
distancing cannot be attained.Careers with Optum. Here's the idea.
We built an entire organization around one giant objective; make
health care work better for everyone. Optum, part of the
UnitedHealth Group family of businesses, brings together some of
the greatest minds and most advanced ideas on where health care has
to go in order to reach its fullest potential. For you, that means
working on high performance teams against sophisticated challenges
that matter. Here you'll find incredible ideas in one incredible
company and a singular opportunity to do your life's best work.
(SM)Diversity creates a healthier atmosphere: Optum and its
affiliated medical practices are Equal Employment
Opportunity/Affirmative Action employers 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. Optum and its affiliated
medical practices is a drug-free workplace. Candidates are required
to pass a drug test before beginning employment.
Keywords: Optum, West Covina , Registered Nurse, Care Manager, Executive , West Covina, California
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