Senior RN Case Manager, Care for Me Program, Float - Las Vegas, NV

UnitedHealth Group•Las Vegas, NV

19d

About The Position

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Clinic Case Manager is responsible for fostering collaboration and a team approach for successfully supporting patients with high-risk health conditions to navigate the healthcare system. Promote empowerment by facilitating the role of an educator, resource, and advocate for patients and their families to ensure a maximum quality of life. Interacts and collaborates with multidisciplinary care teams, to include physicians, nurses, pharmacists, case managers, social workers, and other educators. Works in a less structured, self-directed environment and performs all delegated nursing duties within the scope of a RN license of the applicable state board of nursing. Ensures compliance to contractual and service standards as identified by relevant health insurance plans. Adheres to policies, procedures, and regulations to ensure compliance and patient safety. Participation in Compliance and required training is a condition of employment. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Requirements

Valid NV RN License
Current BLS Certification or willingness to obtain within 3 months of hire
2+ years of job-related experience in a healthcare environment (Hospital/Clinic/Practice)
Knowledge of medical terminology; nursing assessment and follow up on patient’s needs
Proven skilled with MS Office software applications and electronic medical records (EMR)
Proven excellent communication, interpersonal, organization and customer service skills
Positive personality and willingness to effect change
Proven ability to multi-task and work under pressure
Valid NV State Driver’s license and access to reliable transportation

Nice To Haves

Bachelor’s degree or higher in nursing
3+ years of experience providing hospital care (ICU/Floor) or Emergency room (ED) nurse or case management within Hospital/Clinic/Practice

Responsibilities

Role embedded within the primary care clinic, working directly with patients, clinical and non-clinical teams providing transitional case management services
Performs assessment/screening of health conditions; Collaboration with the member, caregiver(s), clinician(s), and/or other appropriate healthcare professionals to address need and goals
Pursues appropriate interventions to reduce risk of condition exacerbation, ER and hospitalization utilization to meet department/organization metrics or goals
Supports transition of care from Emergency Department or inpatient stay to outpatient setting. Assist with referrals (home health/DME) and appointments (PCP/specialist).
Achieves Quality Measures outcomes via reduction in HEDIS Gaps in Care