Call Center Nurse: OptumInsight

UnitedHealth Group•Chesapeake, VA

2d•$29 - $52•Remote

About The Position

The Health Services Nurse is a member of the Nurse Triage Services team. This position is responsible for providing comprehensive clinical services to our customers located throughout the U.S. and may require multiple licenses to practice across various States. Services provided to our customers include but are not limited to the following Telephonic services: Transitions of Care, Medication Adherence and Reconciliation, Management of Gaps in care, and other care extension services. The Health Services Nurse assists and guides patients toward self-management and behavior modifications that result in improved patient outcomes. The Health Services Nurse is the primary point of contact, coordinating with schedulers, pharmacists, providers of medical and behavioral health care and social services. Success is measured in terms of improved patient outcomes, prevention of patient adverse events and unnecessary inpatient readmissions, satisfied customers, meeting, or exceeding quality measures, producing consistent and high-quality work and collaboration with other care team members. The Health Services Nurse is an experienced nurse, able to perform tasks independently and once trained, without significant guidance. This person can provide education to patients, deploying best practices and standard workflow in their daily activities with the ability to apply their expertise across the various areas of responsibility, understanding how their interactions with patients affect customer satisfaction and can make recommendations to improve processes.

Requirements

An associate nursing degree or equivalent clinical experience
Current, unrestricted license issued by a state or jurisdiction within the United States to practice nursing
Must have an active Virginia RN License
3+ years’ experience in an Acute or Managed Care setting
Experience with Electronic Medical Records system(s)
Demonstrated ability to meet deadlines with little to no supervision
Proven ability to work independently and meet productivity expectations daily
Demonstrated solid analytical and interpersonal skills
Demonstrated computer literacy
Demonstrated knowledge of Chronic Illnesses and medications utilized to treat those diseases

Nice To Haves

Proven solid clinical assessment skills and experience in telehealth
Demonstrated competency in managing a caseload of diverse patients across the continuum of care
Demonstrated understanding of health-service related processes relevant to assigned role and responsibilities
Proven ability to train others and answering questions from co-workers when necessary
Demonstrated solid analytical, interpersonal skills, and computer navigation and literacy
Demonstrated knowledge of healthcare, government, and insurance industry trends

Responsibilities

Works on assignments that are semi-complex in nature where ability to recognize deviation from accepted practice is required
Normally receives general instructions on routine work, detailed instructions on new assignments.
May provide guidance to less experienced colleagues
Health Services position in a Managed Services organization (does not reside on Client/Practice site)
Provides Nursing support for health service providers in areas including but not necessarily limited to: Authorization/Utilization Review; Case Mgt; Quality Improvement processes, nurse triage services.