RN Case Manager – Montgomery and Clark Counties, Ohio

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs – helping patients access and navigate care anytime and anywhere.

As a team member of our Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing. This life-changing work adds a layer of support to improve access to care.

We’re connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.

As a Long-term Care and Assisted living Optum Registered Nurse you will function as part of the primary care team, and report to the Clinical Services Manager (CSM). This role works in close collaboration with all of the interdisciplinary team members and may support multiple providers. The RN Case Manager is a flexible team member who works under the direction of the Advanced Practice Clinician (APC) and activities are delegated by the APC or the team Clinical Services Manager (CSM). The Optum Registered Nurse travels to visit members at skilled nursing facilities.

Standard Hours: Monday – Friday 8AM – 5PM; no nights, weekends, or holidays.

Primary Responsibilities: 

• Assist the provider / team with various care coordination activities in the nursing home
• Assist the provider / team with benefit determination associated with Medicare part A, part B, and part D benefits
• Collaborating with the primary Advanced Practice Clinician, (APC) and nursing facility to identify and respond to patient Change in Condition
• May assist the provider by completing Decision Support Tool, (DST), re – assessing the patient, and other activities as delegated by the provider or the Clinical Services Manager (CSM)
• Assist the provider / team with therapy coordination for members including possible assessments or follow up on requests and communicate and collaborate with APC
• May perform interval check in on patient progress with therapy department
• May participate in facility-based therapy discussion meetings
• Schedule and participate in family conferences, team meetings, and team case presentations
• May assist in the coordination of training, tracking and compliance with quality measures
• May participate in the onboarding of new clinical staff under the direction of the CSM Manager which could include coordination of onboarding activities, and participation in other orientation activities
• Participate in facility partnership or Customer Relationship Management (CRM) meetings under the direction of the APC / CSM
• May assist in coordinating CRM meetings, and may participate in and contribute to the meetings
• May assist the team in tracking LearnSource completion for the team members and CSM
• Assist in creating and conduct in – services for selected audiences
• Will document information and activities in the EMR
• May assist Providers in assuring complete and accurate documentation and coding, medication reconciliation, nursing rounds, assessment, and patient documentation
• Assist the team / providers in prioritizing advance Care Planning and initiating discussions
• Collaborates with all key stakeholders, providers, nursing homes, PCPs, families, interdisciplinary care teams and any other identified stakeholders
• Review the chart and enter HEDIS / Quality information into the Electronic Medical Record (EMR), communicate gaps to the Provider
• May write verbal orders from Provider in the chart in compliance with the state RN practice laws, and in compliance with individual nursing facility practices
• Conducting goals of care conversations
• May assist with patient care in the state of Washington, either face-to-face or telephonically

What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• More information can be downloaded at: http://uhg.hr/uhgbenefits

 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.

Required Qualifications:

• Associate degree or higher in Nursing (RN)
• Current unrestricted Registered Nurse license in the state
• Certified in Basic Life Support
• Ability to obtain an unrestricted Registered Nurse license in the state of OHIO within 12 months of employment
• Valid Driver’s License with access to reliable transportation that will enable you to travel up to 100% to visit clients and / or patient sites within a designated area

 

Preferred Qualifications:

• 1+ years of experience in post – acute care, such as long-term care
• 1+ years of experience working with the geriatric population
• 1+ years of experience with using an Electronic Medical Records
• Proven ability to work with diverse care teams in a variety of settings

 

Soft Skill:

• Effective Communication skills and time management

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.    

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. 

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment