Care Manager RN

UnitedHealth Group•Presque Isle, ME

13d•Onsite

About The Position

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? 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. This role is a full-time, onsite role at the Presque Isle, ME facility.

Requirements

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

Nice To Haves

CCM, ACM other certification applicable to care management
Experience in care management
Proven 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