CLINIC LOCATION: Seal Beach, CA
At Optum, we share what might be seen as a surprisingly simple goal: making the health system work better for everyone. We look for people who relentlessly push themselves to go farther. For these high performers, a position on a team at Optum, a business of UnitedHealth Group, is a natural fit. We offer more than the talent, resources and can - do culture - we offer a place to improve the lives of others while doing your life’s best work.(sm)
Optum Care Medical Group serve the communities within Orange and southern Los Angeles counties. The combined medical group is composed of 15 practices with more than 90 physicians and mid-level providers. From pediatric and adolescent medicine, to adult and senior care, Optum Care Medical Group strive to provide a higher level of service through our unique, patient-driven model.
Under the supervision of the Administrator, the Triage Nurse is responsible for the triage of walk-in patients presenting complaints, signs and symptoms of illness that require medical treatment. The Triage Nurse is responsible for the telephonic management of patient calls, prioritizing based on medical necessity. The Nurse is required to rapidly perform an accurate systematic collection of data related to the patient’s chief complaint. Must identify and make appropriate nursing interventions, then provide information to the primary or on-call physician for follow-up.
Schedule: Monday - Friday 8:00am - 5:00pm
- Performs concurrent and retrospective telephonic clinical reviews
- Documenting medical necessity and appropriate level of care utilizing clinical guidelines (Milliman). Complies with CMS regulations and Health Plan requirements
- Interacts and effectively communicates with members, their families and or designated member representative to assess discharge needs and formulate a discharge plan, provide Health Plan benefit information
- Interacts daily with treating physicians regarding the OCMG member's plan of care and alternative care solutions
- Effectively communicates plan of care to facility staff, health plan partners, and ambulatory case management
- Current and unrestricted California LVN or RN licensure.
- 1+ years of experience in acute care or managed care experience
- Microsoft Office -Word / Excel
- Previous experience working with geriatric population
- Experience in utilization management
Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.
Job Keywords: LVN, UM, Ambulatory care, urgent care, RN, Triage, Managed Care, Telephonic, Clinical Review, supervisor, ambulatory setting, medical terminology, EMR, Vendor management, Seal Beach, CA, California