Senior Clinical Admin Consultant RN - Remote from Central Time Zone Preferred

UnitedHealth Group•Eden Prairie, MN

2d•$60,200 - $107,400•Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Clinical Admin Consultant RN (CAC) is responsible for providing expertise as a clinical interface or liaison within the company to resolve and prevent issues concerning initiation and delivery of patient care. The CAC applies their field experience, expertise and clinical nursing assessment skills to: verify physician orders for therapy; determine administration method and patient supply requirements with the pharmacy team; determine nursing care needs and source for these services; coordinate care with subcontracted agencies, trouble shooting and resolving clinical issues, work in multiple applications at one time and execute all tasks with a focus on patient-specific needs. The Senior Clinical Admin Consultant RN also performs other duties as needed based on experience level, including but not limited to implementing Company processes, programs, and new hire training. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

Active and unrestricted compact licensure as a Registered Nurse (RN) in the state(s) of practice and others as requested
2+ years of experience working as an RN in a clinical care setting that contributes to proficiency in infusion therapy (such as medical surgical unit, emergency department, intensive care unit, post-anesthesia care unit, or similar setting)
1+ years of experience working with interdisciplinary healthcare teams that included pharmacy, nursing, payers, case managers/discharge planners, physicians, patients and caregivers
Experience with electronic medical records (EMR) programs and documentation
Knowledge of and experience with Microsoft Office
Proven willing and able to work with an interdisciplinary team of professionals including pharmacists and technicians, physicians and other licensed prescribers, registered dietitians, home health agencies (HHAs), sales representatives, and others as needed to provide comprehensive care and support of patients and caregivers
Proven willing and able to work independently in home
Proven willing and able to assume a flexible work schedule in meeting attendance, and other reliability requirements of the position
Proven effective teaching skills
Proven effective interpersonal communications, both written and verbal
Proven excellent organizational and critical thinking skills

Nice To Haves

Infusion Therapy and/or Home Health Agency experience with specific proficiency in infusion therapy
Experience within a healthcare organization providing coordination and navigation of patient care between providers
Knowledgeable of HIPAA patient privacy and data security requirements, OSHA employee protection regulations, and The ACHC’s accreditation standards for home health and home infusion pharmacy (and other relevant accrediting organizations, as applicable)
Knowledge of and/or experience with current state licensure requirements
Knowledge of the Infusion Nursing Society (INS) standards of practice, policies and procedures

Responsibilities

Provide expertise as an internal clinical resource to operations teams (including other clinicians and subcontracted agencies) for evaluation of patient needs and/or issue resolution, exercising considerable judgment, problem solving skills, and professional knowledge
Maintain a comprehensive knowledge base of infusion therapies administered in the home, utilizing Company policies, procedures and protocols in addition to all available training resources to ensure understanding of each therapy before initiating/coordinating treatment
Completes clinical review of patient referral records and or telephonic data collection, including: current and past medical history; vascular access device (VAD) information; physician orders for appropriateness; ICD-10 code review; and documentation of nursing orders for start of care
Provides timely communication with other company personnel and outside providers, especially physicians and home health agencies, to assure the quality and continuity of patient care
Establish and maintain positive clinical rapport with subcontracted agencies, patients and their families, working closely with them in the coordination of infusion therapy, education related to self-care and self-administration expectations, and clinical monitoring of patient response to therapy
Establish and maintain collaborative relationships with outside agencies and organizations that deliver service on behalf of, or in conjunction with, the Company (e.g., subcontracted home health agencies, durable medical equipment providers, other healthcare team members)
Utilizes Electronic Medical Record (EMR) and documentation systems to clearly communicate patient status during clinical review, coordination of care and ongoing support of patients
Participate in completion and tracking of timely signed receipt of physician orders (Plan of Treatment and Supplemental Orders)
Work with patient care coordinators to triage patient calls to assess needs/issues/complaints/concerns: responding with appropriate urgency; thoroughly evaluating all options for addressing patient needs; and completing all required documentation to reflect actions taken
Support field nursing staff with communication and follow-up required to resolve patient issues/complaints that are reported to the Company
Maintain current nursing licensure in all states in which patients are serviced, as required by the respective State Boards of Nursing and/or Department of Health
Comply with all State and Federal regulations and laws, including employee health and safety protections mandated by the Occupational Safety and Health Administration (OSHA), patient privacy and data security required by the Health Insurance Portability and Accountability Act (HIPAA), as well as all home infusion standards of practice
Serve as a professional representative of the Company when meeting with and/or providing education to external customers, payers and referral sources
Participate in medical record audits and other performance-improvement related activities as assigned by leadership
Complete nurse competency yearly and providing educational reinforcement/ongoing assessment as needed to subcontracted agencies
May be required to work any day or shift as needed
Other duties as assigned