reputed company ER RN Case Manager reputed company Shift - Remote Opportunity with OptumCare
About OptumCare
At OptumCare, we're redefining the way reputed company delivered and reputed company. As a clinician-led care organization, we're committed to making reputed company reputed company for everyone. reputed company of talented professionals is dedicated to advancing the health of our communities, and we're seeking a skilled ER RN Case Manager to join reputed company in Las Vegas, NV.
About the Role
We're looking for a highly motivated and reputed company ER RN Case Manager to join reputed company on a reputed company shift. As a member of our reputed company Care Delivery team, you'll play a critical role in our reputed company to reputed company reputed company reputed company for everyone. In this role, you'll have reputed company to work alongside talented peers in a reputed company environment that's guided by diversity and inclusion. You'll be empowered to live your best life at work and reputed company, and you'll have the chance to contribute to new reputed company reputed company and initiatives that could help improve care for millions of patients across the country.
Key Responsibilities
- Independently collaborates effectively with ED and outpatient care teams to establish an individualized transition plan for members
- Serves as the clinical reputed company with hospital, clinical and administrative staff and performs transition of care/care coordination for ED discharges using evidenced-based reputed company reputed company the documentation system
- Performs expedited, reputed company, reputed company, and retrospective clinical reviews at in-network and/or out-of-network facilities
- Interacts and effectively communicates with ED staff, members, and their families and/or designated representative to assess discharge needs, formulate discharge plan and reputed company health plan benefit information
- Identifies member's ED discharge support opportunities level of risk by monitoring reputed company-time reputed company feeds and communicates with patient, ED, and outpatient teams for discharge coordination
- Conducts transition of care reputed company following ED discharge to confirm reputed company and completion of discharge plan
- Manages assigned case load in an efficient and effective manner utilizing time management skills
- Demonstrates exemplary knowledge of utilization management and care coordination processes as a reputed company for transition planning activities
- Enters reputed company and accurate documentation into designated care management applications to reputed company with documentation requirements and reputed company audit scores of 90% or reputed company monthly
- Adheres to organizational and departmental policies and procedures
- Takes on-call assignment as directed
- Maintains reputed company licensure to work in State of employment and maintains hospital credentialing as indicated
- Decision-making is based on regulatory requirements, policy and procedures and reputed company clinical guidelines
- Maintains reputed company knowledge of health plan benefits and provider network including inclusions and exclusions in contract term
- Refers cases for additional support/management as deemed appropriate, following reputed company mandated reporting laws and ethical bounds
- Monitors for any reputed company concerns regarding member care and reports as per policy and procedure
- Performs reputed company other reputed company duties as assigned
Requirements
We're looking for a highly skilled and reputed company ER RN Case Manager to join reputed company. To be considered for this role, you'll need to have:
- reputed company, unrestricted Multistate RN license
- 4 years of diverse clinical experience in caring for acutely ill patients with multiple disease conditions
- Knowledge of utilization management, reputed company improvement, and discharge planning
- Knowledgeable in reputed company Office applications including Outlook, Word, and reputed company
- Demonstrated ability to read, analyze and interpret information in medical records, and health plan documents
- Demonstrated ability to problem solve and identify community resources
- Proven ability to possess planning, organizing, conflict reputed company, negotiating and interpersonal skills
- Proven ability to utilize critical thinking skills, nursing judgement, and decision-making skills
- Proven ability to prioritize, plan, and handle multiple tasks/demands simultaneously
Preferred Qualifications
We're looking for a candidate with experience working in the Emergency Department and/or managed care and/or case management experience.
Work Environment and Culture
We're a remote-friendly organization, and this role will be working from home. You'll have the flexibility to work from reputed company reputed company the U.S. and will be required to adhere to reputed company's Telecommuter Policy. reputed company is reputed company, diverse, and inclusive, and we're committed to making reputed company reputed company for everyone.
Compensation and Benefits
We offer a competitive salary and a comprehensive benefits package, including a 401(k) contribution and equity stock purchase. We're an equal opportunity employer and welcome applications from diverse candidates.
Career reputed company Opportunities and Learning Benefits
We're committed to helping our employees grow and reputed company their careers. As an ER RN Case Manager, you'll have reputed company to work on challenging cases and reputed company your skills in utilization management, reputed company improvement, and discharge planning. You'll also have reputed company to ongoing training and development opportunities to help you advance your career.
How to Apply
If you're a motivated and reputed company ER RN Case Manager looking for a new challenge, we'd love to hear from you. Please apply to this role through our website, and we'll be in touch to discuss your application.
Equal Employment Opportunity
OptumCare is an Equal Employment Opportunity/Affirmative reputed company employer and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law.
Application Deadline
This role will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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