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As a Long-term Care Optum Registered Nurse you will function as part of the primary care team, and report to the Clinical Services Manager (CSM). This role works in close collaboration with all of the interdisciplinary team members and may support multiple providers. The Senior Case Manager is a flexible team member who works under the direction of the Advanced Practice Clinician (APC) and activities are delegated to the Senior Case Manager by the APC or the team Clinical Services Manager (CSM)
Primary Responsibilities:
- Assist the provider/team with various care coordination activities in the nursing home
- Assist the provider/team with benefit determination associated with Medicare Part A, Part B, and Part D benefits
- Collaborating with the primary APC and nursing facility to identify and respond to patient Change in Condition
- May assist the provider by completing DSTs, re-assessing the patient, and other activities as delegated by the provider or the CSM
- Assist the provider/team with therapy coordination for members including possible assessments or follow up on requests and communicate and collaborate with APC
- May perform interval check in on patient progress with therapy department
- May participate in facility-based therapy discussion meetings
- Schedule and participate in family conferences, team meetings, and team case presentations
- May assist in the coordination of training, tracking and compliance with quality measures
- May participate in the onboarding of new clinical staff under the direction of the CSM Manager which could include coordination of onboarding activities, and participation in other orientation activities
- Participate in facility partnership or Customer Relationship Management (CRM) meetings under the direction of the APC/CSM
- May assist in coordinating CRM meetings, and may participate in and contribute to the meetings
- May assist the team in tracking Learn Source completion for the team members and CSM
- Assist in creating and conduct in-services for selected audiences
- Will document information and activities in the EMR
- May assist Providers in assuring complete and accurate documentation and coding, medication reconciliation, nursing rounds, assessments, and patient documentation
- Assist the team/providers in prioritizing advance Care Planning and initiating discussions
- Collaborates with all key stakeholders, providers, nursing homes, PCPs, families, interdisciplinary care teams and any other identified stakeholders
- Review the chart and enter HEDIS/Quality information into the EMR, communicate gaps to the Provider
- May write verbal orders from Provider in the chart in compliance with the state RN practice laws, and in compliance with individual nursing facility practices
This is a field base position
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 Registered Nurse license in the state of Texas
- 1+ years of experience in post-acute care, such as long-term care
- 1+ years of experience working with the geriatric population
- 1+ years of experience with using electronic medical records
- Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
Preferred Qualifications:
- Bachelor's degree
- Experience with Medicare Part A, Part B, and Part D benefits
- Experience with the long-term care business environment
- Experience conducting in-services
- Demonstrated basic Microsoft Office skills with the ability to navigate in a Window's environment
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
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.