Case Manager RN - Per Diem - Boulder, CO at Optum

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.  

The Case Manager RN is responsible and accountable for coordination of patient services through an interdisciplinary process, which provides a clinical and psychosocial approach through the continuum of care.  Through concurrent case management, patients will be assessed to determine appropriateness of admission, continued hospitalization, as well as appropriate level of care. Discharge planning will begin at the time of (or prior to) admission, and reassessed ongoing throughout the course of hospitalization.  Quality and Risk Management issues will also be monitored for and reported as appropriate.

Location: 4747 Arapahoe Ave, Boulder, CO 80303 (Boulder Community Health)

Schedule: Minimum of two working days per pay period which would include the ability to commit to 1 weekday and ability to commit to 1 weekend day 

Primary Responsibilities:

• Directly communicates with staff, physicians, patients and families
• Coordinates patient care processes to achieve desired quality outcomes and identifies/controls inappropriate resource utilization
• Facilitates patient and family education and promotes continuity of care to achieve optimal patient outcomes.  Assures patient rights by offering a choice when appropriate
• Reviews the patient plan of care with the multi-disciplinary team.  Facilitates and participates in multi-disciplinary team care conferences for patients with complex problems.  Communicates in the medical record and verbally with the team to coordinate interventions and facilitate continuity of care
• Daily communication and collaboration with the patient care staff to provide continuous assessment, evaluation and continuum planning to assure the patient receives the appropriate level of care at the appropriate time.  Facilitates the implementation of nursing interventions as indicated by the multi-disciplinary team plan of care that enhances and compliments the skill level of the nursing staff
• Functions without direct supervision, utilizing time constructively and organizing assignments for maximum productivity.  Arranges schedule to facilitate meeting with physicians for patient care rounds, team meetings and other opportunities to improve communication
• An initial assessment is required to be completed for all inpatients within 36 hours of admission (Per employee average caseload of 12 patients per day)
• Excess Days per Patient discharge should remain under 1.39 days per contract requirements
• Individual Expectation: Employees are to document a daily intervention on all patients
• Operation Expectation: Employees are required to lead daily Interdisciplinary Rounds for their patients on a specific medical unit to drive timely discharges and plans of care
• CMS Compliance: All Medicare and Medicare Advantage patients are required a delivery notice for MOON & IMM documentation. All patients are also required to be provided with choice for discharge dispositions

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:

• Associate’s Degree (or higher)
• Valid unrestricted RN License in the state of Colorado OR Master of Social Work (MSW) Degree
• Ability to commit to working 1 weekend day per pay period (1 weekend day every 2 weeks)

Preferred Qualifications:

• Bachelor of Science in Nursing (BSN)
• Case Management Certification 
• 2+ years of recent clinical or case management experience in area of specialization 
• Knowledge/understanding of community resources, policies, and procedures

Soft Skills:

• Solid analytical, critical thinking and organizational skills 

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: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, 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. 

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

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