RN Care Manager - Hybrid in Northgate, WA

UnitedHealth Group • Seattle, WA

120d • $58,800 - $105,000

About The Position

Optum WA, is seeking a RN Care Manager to join our team in Northgate, WA. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone. At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. Complex care case management seeks to provide thoughtful, tailored nursing support to patients across a spectrum of illnesses of varying severity and progression. Our patients may be anywhere along a continuum from adjusting to a “new normal” all the way through to transitioning to hospice care. Many of our patients dealing with serious illness benefit from assistance in understanding their medical reality. Therefore, this position integrates palliative approaches to care in our primary care setting. This role works closely with physicians, social workers, other specialty teams (like palliative care, oncology, etc.) to ensure coordinated and value-concordant care. In addition, CM RN will work closely with colleagues in local hospitals, SNFs, and hospices. RN CM will participate in multi-disciplinary team meetings to coordinate an iterative plan of care for our most complex, high-risk patients, as well as those dealing with natural decline. This complex work benefits from a nursing approach that is focused on creative problem solving and big-picture awareness rather than short-term solutions and reliance on strict rubrics. Position in this function provides physicians and other health care professionals with appropriate care management tools, support, education and information to enable real time clinical decision-making. Delegates specific tasks of plan of care to Medical Assistants and Health Coaches and oversees the plan of care to ensure protocols are followed and desired outcomes are achieved. Practices within the scope of nursing rules and regulations as established by the Washington Department of Health. Complies with all reporting requirements, including operational protocol submittals. Provides effective care management across the care continuum and suggests and implements methods to improve cost effectiveness and quality of care.

Requirements

• Graduation from an accredited school of nursing
• Active Registered Nurse license through the Washington State Department of Health
• 2+ years of professional nursing experience
• Proven knowledge of medical terminology and managed care
• Driver’s License and access to reliable transportation

Nice To Haves

• Case management certification
• Ambulatory and inpatient experience
• Knowledge of ICD and CPT coding
• Knowledge of professional nursing theory and practice to assess, plan, implement and evaluate patient care
• Knowledge of organizational policies, regulations and procedures to administer patient care
• Knowledge of medical equipment and instruments, common safety hazards, and precautions to establish a safe work environment
• Knowledge of relevant resources within the organization and community

Responsibilities

• Care Management activities include early identification of high-risk patients, concerted planning involving physicians and mid-level practitioners, monitoring of services provided by outside physicians, home health, DME, and other providers; monitoring emergency department use as well as identifying opportunities to decrease emergency department utilization and other elements of care utilization
• Provides effective care management across the care continuum, including coordination involving internal and external providers of care, families and other entities, as appropriate
• Works in collaboration with colleagues in multiple care settings to determine patients’ barriers and needs utilizing clinical skills and independent decision making
• Engages in proactive, concurrent care management for patients with chronic or complex medical conditions
• Performs visits to patient home, skilled nursing home stays or while in-patient at a neighboring hospital

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees