Geriatric Complex Care RN Case Manager

Company: Optum
Location: Everett
Posted on: January 9, 2022

Job Description:

The Everett Clinic, part of Optum, is seeking a Geriatric Complex Care RN Case Manager to join their Primary Care Department full time onsite in Everett, working a 4-10 schedule.*We are offering a $7500 Sign on Bonus for this position.*The Geriatric Complex Care RN Case Manager functions as an integral member of the healthcare team and is responsible for: Under minimal supervision, responsible for ensuring the continuity of care in the outpatient setting utilizing the appropriate resources within the parameters of established contracts and patients' health plan benefits. Facilitates continuum of patients' care utilizing advanced nursing knowledge, experience and skills to ensure appropriate utilization of resources and patient quality outcomes. Performs care management functions on-site and telephonically as the need arises. Works in conjunction with the care team and PCP as care team leader to develop a patient centered plan of care. The Geriatric Complex Care RN Case Manager is responsible for and not limited to:

• Prioritizes patient care needs upon initial visit and addresses emerging issues.
• Meets with patients, patients' family and caregivers as needed to discuss care and treatment plan.
• Identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings.
• Consults with physician and other team members to ensure that care plan is successfully implemented.
• Coordinates treatment plans with the care team and triages interventions appropriate to the skill set of the team members. Uses protocols and pathways in line with established disease management and care management programs in order to optimize clinical outcomes and minimize unnecessary institutional care.
• Monitors and coaches patients using techniques of motivational interviewing and behavioral change to maximize self-management.
• Oversees provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc. in order to maintain continuity of care.
• Works in coordination with the care team and demonstrates accountability with patient management and outcome.
• Discusses Durable Power of Attorney (DPOA) and advanced directive status with patient and PCP when applicable.
• Maintains effective communication with the physicians, hospitalists, extended care facilities, patients and families.
• Provides accurate information to patients and families regarding resources available to them through health plan benefits, community resources, and referrals.
• Participates actively in Monthly Care Management Department meetings and daily huddles.
• Documents pertinent patient information and Care Management Plan in Electronic Health Record.
• Coordinates care with central departments on assigned patient caseload, including, inpatient, long term care facilities, adult family homes, and home health agencies.
• Demonstrates a thorough understanding of the cost consequences resulting from Care Management decisions through utilization reports and systems such as Health Plan Benefits, CM dashboards and reports.
• Maintains concise and accurate documentation that supports effective and efficient management of care plans to decrease Emergency and hospital readmissions.
• Adheres to departmental policies and procedures. Uses, protects, and discloses HCP patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Participates in training all new care managersPreferred Experience and Credentials:
  • Knowledge: Knowledge of current standards of patient care. Thorough understanding of RN scope of practice. Knowledge of ICD and CPT coding preferred; knowledge of medical terminology and managed care required. Knowledge of organizational policies, regulations and procedures to administer patient care. Knowledge of medical equipment and instruments, common safety hazards, and precautions to establish a safe work environment.
    • Skills: Skill in identifying problems, researching and recommending solutions. Skill in preparing and maintaining records and establishing and maintaining effective working relationships with patients, medical staff and the public. Good professional communications and interpersonal skills. Strong organizational skills to set priorities and ability to work with high degree of accuracy and attention to details while responding to tight deadlines and multiple priorities and demands.
      • Abilities: Computer literate, and ability to type 25 wpm. Ability to effectively communication and collaborate with physicians, patients, families, and teammates. Ability to make sound, independent judgements and act professionally under pressure. Manual dexterity to use/handle equipment and instruments.
        • Education: Bachelors degree from a four-year college and/or professional certification requiring formal education beyond a two-year college; Bachelors degree in Nursing preferred. Graduation from an accredited school of Nursing.
          • Experience: Minimum of three (3) to five (5) years experience in clinical setting demonstrating the ability to assess, document, and implement the nursing care plan; minimum of three (3) to five (5) years of acute nursing experience in critical care. Previous care management, utilization review or discharge planning experience, and HMO experience, preferred.
            • Certificate/License: Washington State Registered Nurse license. Basic Life Support (BLS) for Healthcare providers (AHA). A Washington State drivers license and vehicle for work-related travel, required. Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Keywords: Optum, Everett , Geriatric Complex Care RN Case Manager, Healthcare , Everett, Washington