Care Manager RN – Per Diem

UnitedHealth Group•Portland, ME

5d•$28 - $50•Onsite

About The Position

The Care Manager RN – Per Diem provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients/caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Facilitates appropriate LOS, patient experience, and reimbursement for all patients. Develops and maintains collaborative relationships with all members of the healthcare team. Through clinical care coordination drives efficient utilization of resources to reduce length of stay, improve patient flow and throughput, limits variation by applying innovative and evidence-based practice, and to reduce the risk of readmission.

Requirements

Associate's Degree (or higher) in Nursing
Current, unrestricted RN license in the state of employment
1+ years of experience in a hospital, acute care, or direct care setting
Intermediate level of proficiency to navigate Windows based environment and the ability to type
Ability to work one Saturday, quarterly

Nice To Haves

Bachelor’s Degree in Nursing (BSN)
Previous background in managed care
Certified Case Manager (CCM)
1+ years of Case management experience
Experience or exposure to discharge planning

Responsibilities

Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an educational resource to all Health System staff regarding utilization review
Assumes roles in assessment physical, psychosocial, & economic needs for transition of care planning to a variety of levels of care, delegates to others as appropriate
Documents, verifies, and validates specific data required to monitor and evaluate interventions and outcomes
Interviews and collects patient specified data and chart review related to readmission and appropriately notifies care team
Communicates telephonically and electronically with outpatient providers to enhance the continuum of care
Integrates performance improvement principles and customer service excellence principles into all aspects of job responsibilities, practice and governmental commercial payer guidelines
Adheres to the policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodies
Assume responsibility for Health System required continued education and owns professional growth
Performs tasks of a clinical nature within scope of assigned duties and clinical expertise
Communicate effectively in both oral and written form, as appropriate for the needs of the audience
Performs other duties as assigned or required