Care Manager RN - Presque Isle, ME

UnitedHealth Group•Presque Isle, ME

4d•Onsite

About The Position

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with patients/caregivers and multidisciplinary healthcare teams. Facilitates appropriate length of stay (LOS), patient experience, and reimbursement for all patients. Provides leadership in patient-centered care coordination across the continuum. Develops safe discharge plans and arranges appropriate post-discharge services. Drives appropriate DRG length of stay, patient experience, and reimbursement. Promotes patient advocacy in an independent care model.

Requirements

Current, unrestricted RN license in the state of Maine
2+ years of experience in a hospital, acute care or direct care setting
Willing to work on site at the hospital, Monday – Friday
Proven solid communication skills; written, verbal, and in person.
Proven ability to type and have the ability to navigate a Windows based environment
Proven ability to develop and maintain positive relationships with internal and external customers
Demonstrates accountability for decisions and behaviors, exercises critical thinking, clinical rationale, and ethical decision-making

Nice To Haves

CCM, ACM other certification applicable to care management
Experience in care management
Knowledge of care coordination, discharge and transition planning, and community resources

Responsibilities

Maintains knowledge of care management, care coordination, authorizations, and regulatory requirements
Assesses physical, psychosocial, and economic needs for transition of care planning
Documents and validates data required to monitor and evaluate interventions and outcomes
Communicates with outpatient providers to enhance the continuum of care
Integrates performance improvement and customer service principles
Adheres to hospital policies and state and federal regulations
Performs other duties as assigned