RN, Case Manager - Hybrid

Position Overview

As a Registered Nurse, Care Manager at Optum's Pacific West region, you will play a crucial role in providing professional nursing care by assessing, planning, implementing, and evaluating patient care. This position emphasizes health equity, affordability, quality, and convenience, aiming to improve the health of over 2.5 million patients. You will work in a hybrid environment, balancing remote and in-office responsibilities, while collaborating closely with clinicians and staff to ensure efficient department operations and optimal patient outcomes.

Key Responsibilities

• Prioritize patient care needs upon initial visit and address emerging issues.
• Meet telephonically with patients, families, and caregivers to discuss care and treatment plans.
• Identify and assist with the follow-up of high-risk patients in various care settings.
• Consult with the physician and other team members to ensure successful implementation of care plans.
• Use protocols and pathways aligned with established disease and care management programs.
• Monitor and coach patients using motivational interviewing techniques.
• Oversee provisions for discharge from facilities to maintain continuity of care.
• Coordinate with the care team and demonstrate accountability with patient management.
• Discuss Durable Power of Attorney (DPOA) and advanced directive status with patients and PCP.
• Maintain effective communication with physicians, hospitalists, and patients.
• Provide accurate information to patients regarding available resources.
• Participate actively in Monthly Care Management Department meetings and daily huddles.
• Document pertinent patient information and Care Management Plans in Electronic Health Records.
• Coordinate care with central departments on assigned patient caseload.
• Demonstrate understanding of cost consequences of Care Management decisions.
• Maintain concise and accurate documentation to decrease Emergency and hospital readmissions.
• Adhere to departmental policies and procedures.
• Participate in training all new care managers.

Required Qualifications

• Graduation from an accredited school of nursing.
• Active, unrestricted Registered Nurse license through the State of California.
• 1+ years of experience in a clinical setting or care management.

Preferred Qualifications

• Bachelor of Science in Nursing, BSN.
• Telehealth certification.
• 3+ years of experience working in acute care.
• 1+ years of care management, utilization review or discharge planning experience.
• HMO experience.

Benefits & Perks

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution