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Care Manager RN

Company: Optum
Location: Tacoma
Posted on: August 3, 2020

Job Description:

Care M anager - RN

Northwest Physicians Network is now offering qualified candidates an opportunity to join our team as a Care Manager. Our company values innovative problem solvers promotes personal and professional growth, and provides a supportive working environment that affords all team members a healthy work/life balance.

The Care Manager - Registered Nurse provides ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs.  The goal of this position is to enhance the quality of patient management and satisfaction, by promoting continuity of care and cost effectiveness through the integration and functions of case management, utilization review and discharge planning.  It is the purpose of the case manager to ensure that the medical and psychosocial needs of the patients are met. This position assists patients and their families/significant others in making appropriate choices regarding the use of health care services. Case management services may be provided telephonically, in the provider office, at patient’s home or in the hospital setting. Clinical nursing experience is a must. Our focus is on finding a team member who is resourceful, highly reliable, has strong problem-solving skills and displays and fosters teamwork.

Northwest Physicians Network creates the opportunity for independent private practitioners to thrive in Washington State. By providing clinical integration support and data driven quality improvement, we have created a high value delivery network, making it possible for our providers to remain focused squarely on their patients.

Status: Regular, Full-time, FLSA Exempt

Base Salary: D.O.E+ Competitive Benefits

Primary responsibilities will include:

Decreases healthcare costs of enrollees by working collaboratively with the case management team to assist members in managing visits to Primary Care Providers offices, decrease ER Utilization, number of hospitalizations, and number of readmits to hospital, skilled nursing facilities and home health

Assesses and prioritizes case referrals to assure health plan requirements for outreach and engagement are within expected time frames

Provides patient and family education, support and encouragement, especially to enhance adherence to treatment regimen and follow up care

When appropriate, facilitates successful transfer of patients to SSI and other appropriate local, state or federal programs

Develops communication protocols with physicians in the network and community so that early notification and intervention by the case management team occurs for patients

Keeps current on areas of case management, quality management, utilization management, patient education and preventive health guidelines

Assesses reports, data, and other health plan information to identify potential patients in need of case management intervention

Develops and implements patient-centered aftercare plans

Acts as liaison and patient advocate with other care providers

Integrates, coordinates and advocates for complex mental and physical health care services from a variety of health care providers and settings, within the framework of planned health outcomes

Develops and implements health care planning and assessment tools for the care management team based on evidence-based practice guidelines

Develops an effective support system within the family and community to manage emergency situations and to provide support and safety for the patient

Acts to prevent suicide and homicide in accordance with state licensure requirements

Assist patients in the management of illness and treatment, monitoring adherence, and proactively investigating and addressing problems that may contribute to non-adherence with the patient and other members of the multidisciplinary team

Presents current inpatient and complex cases before UM/QI Committee when necessary

Compiles information from workload and other statistical data to prepare reports that demonstrate health care trends within NPN’s patient population

Coordinate with Behavioral Health Case Manager on cases with mental health component, dual manage as necessary

Minimum Requirements:

Associates Degree from accredited Nursing program, BSN preferred

3 years’ broad based clinical experience

Current unrestricted Nursing license for the State of Washington, Case Management Certificate Preferred, mandatory after two years of employment

Current driver’s license

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. 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. Here you’ll find incredible ideas in one incredible company and a singular opportunity to do your life's best work.(SM)

Diversity creates a healthier atmosphere: Optum and its affiliated medical practices are 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. Optum and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Care M anager - RN

Northwest Physicians Network is now offering qualified candidates an opportunity to join our team as a Care Manager. Our company values innovative problem solvers promotes personal and professional growth, and provides a supportive working environment that affords all team members a healthy work/life balance.

The Care Manager - Registered Nurse provides ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs.  The goal of this position is to enhance the quality of patient management and satisfaction, by promoting continuity of care and cost effectiveness through the integration and functions of case management, utilization review and discharge planning.  It is the purpose of the case manager to ensure that the medical and psychosocial needs of the patients are met. This position assists patients and their families/significant others in making appropriate choices regarding the use of health care services. Case management services may be provided telephonically, in the provider office, at patient’s home or in the hospital setting. Clinical nursing experience is a must. Our focus is on finding a team member who is resourceful, highly reliable, has strong problem-solving skills and displays and fosters teamwork.

Northwest Physicians Network creates the opportunity for independent private practitioners to thrive in Washington State. By providing clinical integration support and data driven quality improvement, we have created a high value delivery network, making it possible for our providers to remain focused squarely on their patients.

Status: Regular, Full-time, FLSA Exempt

Base Salary: D.O.E+ Competitive Benefits

Primary responsibilities will include:

Decreases healthcare costs of enrollees by working collaboratively with the case management team to assist members in managing visits to Primary Care Providers offices, decrease ER Utilization, number of hospitalizations, and number of readmits to hospital, skilled nursing facilities and home health

Assesses and prioritizes case referrals to assure health plan requirements for outreach and engagement are within expected time frames

Provides patient and family education, support and encouragement, especially to enhance adherence to treatment regimen and follow up care

When appropriate, facilitates successful transfer of patients to SSI and other appropriate local, state or federal programs

Develops communication protocols with physicians in the network and community so that early notification and intervention by the case management team occurs for patients

Keeps current on areas of case management, quality management, utilization management, patient education and preventive health guidelines

Assesses reports, data, and other health plan information to identify potential patients in need of case management intervention

Develops and implements patient-centered aftercare plans

Acts as liaison and patient advocate with other care providers

Integrates, coordinates and advocates for complex mental and physical health care services from a variety of health care providers and settings, within the framework of planned health outcomes

Develops and implements health care planning and assessment tools for the care management team based on evidence-based practice guidelines

Develops an effective support system within the family and community to manage emergency situations and to provide support and safety for the patient

Acts to prevent suicide and homicide in accordance with state licensure requirements

Assist patients in the management of illness and treatment, monitoring adherence, and proactively investigating and addressing problems that may contribute to non-adherence with the patient and other members of the multidisciplinary team

Presents current inpatient and complex cases before UM/QI Committee when necessary

Compiles information from workload and other statistical data to prepare reports that demonstrate health care trends within NPN’s patient population

Coordinate with Behavioral Health Case Manager on cases with mental health component, dual manage as necessary

Minimum Requirements:

Associates Degree from accredited Nursing program, BSN preferred

3 years’ broad based clinical experience

Current unrestricted Nursing license for the State of Washington, Case Management Certificate Preferred, mandatory after two years of employment

Current driver’s license

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. 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. Here you’ll find incredible ideas in one incredible company and a singular opportunity to do your life's best work.(SM)

Diversity creates a healthier atmosphere: Optum and its affiliated medical practices are 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. Optum and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: Optum, Tacoma , Care Manager RN, Other , Tacoma, Washington

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