OVERVIEW OF POSITION:
Responsible for all activities associated with regional care management programs (inpatient and ambulatory). Ensures all care management activities are efficient, effective and meet regulatory requirements. Monitors staff performance, provides mentorship and recognizes and manages departmental opportunities that impact outcomes.
- Consistently exhibits behavior and communication skills that demonstrate Optum’s commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
- Develops and maintains strong and lasting team member and partner relationships.
- Meets productivity targets and serves as an example to team members.
- Exhibits behavior and communication skills that demonstrate commitment to superior patient care, patient experience and patient outcomes.
- Ensures that the regional care management programs meet and exceed compliance adherence; CMS, health plan delegation and quality.
- Develops, implements and analyzes data to support best practice outcomes for care management programs.
- Meets auditing timeframes and proactively manages gaps and interventions.
- Identifies need for and participates in the development and implementation of care management operating procedures.
- Identifies and proactively manages staffing efficiencies and productivity, ensuring efficient management of resources.
- Collaborates with staff, stakeholders and clinicians to provide a patient centric approach to care management.
- Serves as subject matter expert in care management programs and processes.
- Supports and guides staff to be accountable in decision making.
- Develops tools and ensures resources are available to support accountable decision making.
- Uses, protects, and discloses Optum patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
- Performs additional duties as assigned.
- Bachelor’s degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college preferred.
- Graduate from an accredited school of Nursing.
- Current California LVN / RN license.
- Bachelor’s degree in Nursing or related field preferred.
- Preferred Certification Case Management.
- 2 years of experience in a position of manager or higher.
- 2 to 3 years management experience in case management.
KNOWLEDGE, SKILLS, ABILITIES:
- Computer literate.
- Ability to work with multiple computer platforms simultaneously.
- Demonstrates strong communication skills, both written and verbal.
- Knowledge of current standards of patient care.
- Thorough understanding of LVN / RN scope of practice.
- Manual dexterity to use/handle equipment and instruments.
- Ability to effectively communicate and collaborate with physicians, patients, families and ancillary staff.
- Ability to make sound, independent judgments and act professionally under pressure.
If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.
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.