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UnitedHealth Group Oncology RN Case Manager - OptumCare - 1500 Sign On Bonus for External Candidates only in Henderson, Nevada

We're making a strong connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today!

Primary Responsibilities:

  • Manage Oncology high risk patients.

  • Oversee systems for identification of the high-risk oncology patient through EMR, referrals, admissions and discharges and from the providers, staff and payorGather clinical information from the EMR and outside medical reporting to determine risk stratification. This includes a comprehensive assessment of physical emotional, psychosocial and environmental needs of the patient.

  • Develop a tracking system for patient care coordination and care management across the continuum including care transitions, primary and specialty care.

  • Act as the liaison for other care management and specialty programs, including United Health Care, Southwest medical Associates, Optum Care, and commercial payors and out of the area providers.

  • Communicate with providers and multidisciplinary care team members to facilitate transition of services.

  • Complete and submit all documentation within established guidelines.

  • Participate in the measurement and evaluation of your work and current practices through the use of clinical audit, outcome measures and reflective practice. Make recommendations for change.

  • Collaborate with multidisciplinary team members in acute, post-acute and outpatient setting to identify patient’s needs as it relates to the oncology specialty and assist to identify patient needs such as home health care DME and community services

  • Assist establishing the case management assessment and document.

  • Document clinical assessments and care plans in the system developed

  • Complete ongoing evaluation and documentation of patient progress in EMR

  • Implement the medical treatment plan by providing counseling regarding the oncology program, initial contact post discharge, counseling regarding the discharge plan and recommendations and treatment adherence issues.

  • Follow-up with patient’s 24 to 48 hours post discharge

  • Identify gaps or barriers in treatment plans to ensure that discharged patients receive appropriate resources and services

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:

  • Current, unrestricted NV RN license or temporary NV RN license with the ability to obtain permanent NV RN license upon expiration of temporary NV RN license

  • 3+ years of clinical nursing experience with direct patient care in an acute care setting (preferably Oncology, Critical Care, general ICU)

  • 1+ years of Case Management experience

  • Must be able to type and have ability to navigate a Windows based environment

  • Excellent interpersonal and communication skills required.

  • Strong organizational and analytical skills, along with proven ability to manage multiple assignments in fast-paced environment.

Preferred Qualifications:

  • Bachelor's Degree in healthcare or related field or working towards a Bachelor's Degree

  • Case management/discharge planning experience is strongly preferred. Advanced certification is preferred such as the Accredited Case Manager (ACM) Certification OR Certified Case Manager (CCM)

  • Previous experience with oncology patient population and families is strongly preferred

  • Background in managed care, experience or exposure to discharge planning

  • Experience in utilization review, concurrent review or risk management

  • Computer / typing proficiency to enter / retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software application

  • Bilingual skills

Answer the call to use your diverse knowledge and experience to make health care work better for our patients. Join us and start doing your life's best work.SM

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

Diversity creates a healthier atmosphere: OptumCare 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.

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

Job Keywords: Registered Nurse, RN, case manager, case management, managed care, telephonic, health care, healthcare, oncology case manager, oncology

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