Nurse - RN - Complex Case Manager - Optum Care Network of Connecticut
Location: Farmington, Connecticut
Internal Number: 109077845
** $1,000 sign on bonus for all external hires **
This position is partially remote and partially based in Farmington CT
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)
If you want to get way ahead in your career, it makes sense to be with an organization's that's way ahead of the curve. Formed in 1997, ProHealth Physicians, part of OptumCare, has grown to become Connecticut’s leading primary care physician organization. With over 90 locations throughout the state of Connecticut, our family of primary care doctors and specialists care for more than 360,000 people statewide. In fact, ProHealth serves every county and provides roughly ten percent of the primary care delivered to patients in the state. We're leaders in thinking and in serving our communities. For instance, we're a C.M.S. approved Accountable Care Organization (ACO), covering over 30,000 Medicare patients associated with our community-based primary care providers. We're also nationally recognized as a NCQA Level III Medical Home. That kind of progressive leadership makes us perfect fit for OptumCare and UnitedHealth Group's expanding family of providers.
ProHealth Physicians (OptumCare Co) has an immediate opening for a Nurse - RN, Complex Case Manager. Under general administrative direction, coordinate referrals from physicians and health care facilities for Members; provides a significant level of Member education related to their illness and planned treatment.
This is a full time position with:
Full Medical Benefits
Paid Time Off
401k with company match
Employee Stock Purchase Plan
Employee Discount Program
Tuition Assistance Program
Member Care Coordination. Works closely with physicians involved in member’s plan of care to coordinate care plan communication; works with multidisciplinary team to maintain and implement up-to-date coordinated care plan; communicates with all members of the healthcare team on behalf of the Member
Member Referral Support: Assists physician providers, Members and their families in obtaining referrals to needed specialists. Provides support and counseling, as appropriate to the clinical situation
Care Plan Development. Works with designated physicians to develop and maintain Member Care Plans
Clinical Improvement. Proactively participates in the development and deployment of Coordination of Care activities with the goal of improving the clinical experience for referred Members and the referring physician.
Liaison. Communicates with members of the Care Team as appropriate to coordinate the identified Member and physician’s needs
Provider/Member Education. Educate Member and care team participants on community/health plan benefit services available.
As Needed. Performs various duties as needed to successfully fulfill the function of the position in conjunction with Medical Management
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.
Bachelor's Degree in Nursing (BSN)
Unrestricted current CT Nursing License
2+ years of experience as a nurse case manager
2+ years of experience managing complex disease states
1+ years of telephonic health plan case management, Utilization Management or Concurrent review experience
Must have the ability to navigate a Windows based environment
Ability to travel up to Farmington CT for training and meetings as needed. Possible travel to other locations at times. Position will be patrially remote based
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.
Certified Case Manager
5+ years of experience as a nurse case manager
5+ years of experience managing complex disease state
2+ years of telephonic health plan case management, Utilization Management or Concurrent review experience
Home care or hospice case management experience
Experience with Electronic Health Records
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. 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. Optum, incredible ideas in one incredible company and a singular opportunity to do 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.
Connecticut Residents Only: The salary range for Connecticut residents is $60,000 to $106,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
**PLEASE NOTE** The Sign On Bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis (“Internal Candidates”) are not eligible to receive a Sign On Bonus.
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