RN Case Manager, Telephonic - Hybrid - Las Vegas, NV
About The Position
Optum NV is seeking a RN Case Management to join our team in Las Vegas, NV. 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.
Requirements
- High School diploma or equivalent
- Registered Nurse with active unrestricted license in the State of Nevada
- 3+ years of direct patient care nursing with a focus on discharge planning or case management
- Knowledge of UM and plan benefit designs
- Solid clinical knowledge and capacity for continued learning
- Proficient in critical thinking skills of RN Case manager
- Demonstrated ability to perform case management activities
- Proven solid verbal and written communication skills
- Proven competent with MS Office and other practice management systems or possess the ability to continue to learn new things
- Proven ability to organize and prioritize tasks for self and patients
- Must possess a valid Nevada driver’s license and maintain personal auto insurance coverage
Nice To Haves
- Bachelor’s degree in healthcare or related field or working towards completion of Bachelor’s degree
- CCM certification
Responsibilities
- Apply case management standards of practice to focus on effective care of high risk high need patients empanelled to non-SMA PCP’s
- Serve as a patient advocate and resource and provide critical information and recommendations to the rest of the care team
- Participates in assessment activities to develop individualized plans of care in coordination with patient, family and providers
- Follows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care delivery. Works together with Medical Director to determine effective plans of care in the prevention of readmissions to acute care
- Maintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomes
- Works collaboratively with primary care to ensure patient compliance and adherence to medical plan of care
- Assist clinicians in implementing best practices for chronic care and disease management
- Follow standard protocols, processes and policies to include but not limited to the following: Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designee
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
