Case Manager RN, Per Diem - Fayetteville, NC

Optum • Fayetteville, NC

406d

About The Position

The Long-term Care Optum Registered Nurse will be part of the Senior Community Care product team, focusing on providing care to patients in nursing homes and assisted living facilities. This role involves collaborating with interdisciplinary teams to ensure seamless care coordination and support for patients' physical, mental, and social needs. The position requires face-to-face interaction with patients and is primarily onsite at long-term care facilities in the greater Fayetteville, NC area.

Requirements

• Current, unrestricted RN license in the state of North Carolina.
• Valid Driver's License with access to reliable transportation.
• 1+ years of experience with using an Electronic Medical Record.
• Ability to be in greater Fayetteville, NC / Cumberland County going into facilities 100% of the time.

Nice To Haves

• 1+ years of experience in post-acute care, such as long-term care or critical care.
• 1+ years of experience working with the geriatric population.
• Proven ability to work with diverse care teams in a variety of settings.
• Proven effective communication skills and time management.

Responsibilities

• Assist the provider/team with various care coordination activities in the nursing home.
• Assist the provider/team with benefit determination associated with Medicare part A, part B, and part D benefits.
• Collaborate with the primary Advanced Practice Clinician (APC) and nursing facility to identify and respond to patient changes in condition.
• May assist the provider by completing DSTs, re-assessing the patient, and other activities as delegated by the provider or the Clinical Services Manager (CSM).
• Assist the provider/team with therapy coordination for members including possible assessments or follow-up on requests and communicate and collaborate with APC.
• May perform interval check-ins on patient progress with the therapy department.
• Participate in facility-based therapy discussion meetings.
• Schedule and participate in family conferences, team meetings, and team case presentations.
• Assist in the coordination of training, tracking, and compliance with quality measures.
• Participate in facility partnership or Customer Relationship Management (CRM) meetings under the direction of the APC/CSM.
• Assist in coordinating CRM meetings, and may participate in and contribute to the meetings.
• Assist the team in tracking LearnSource completion for the team members and CSM.
• Assist in creating and conducting in-services for selected audiences.
• Document information and activities in the EMR.
• Assist Providers in assuring complete and accurate documentation and coding, medication reconciliation, nursing rounds, assessment, and patient documentation.
• Assist the team/providers in prioritizing advance care planning and initiating discussions.
• Collaborate with all key stakeholders, providers, nursing homes, PCPs, families, interdisciplinary care teams, and any other identified stakeholders.
• Review the chart and enter HEDIS/Quality information into the EMR, communicate gaps to the Provider.
• May write verbal orders from Provider in the chart in compliance with the state RN practice laws, and in compliance with individual nursing facility practices.

Benefits

• Opportunities for professional development and career growth.
• Recognition for performance in a challenging environment.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: No Education Listed