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RN Care Manager

Company: Optum
Location: Everett
Posted on: June 11, 2021

Job Description:

The Primary Care department is seeking an RN Care Manager to join their team full time onsite in Stanwood. 

The RN Care Manager functions as an integral member of the healthcare team and is 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 RN Care Manager is responsible for but not limited to: 

  • Calls patients from assigned caseload, referral or may meet 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.

Preferred Experience and Credentials:

  • 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.
  • Skill in identifying problems, researching and recommending solutions. Strong organizational skills to set priorities and ability to well independently.
  • Bachelor’s degree in Nursing preferred. Associate’s degree in Nursing required. Graduation from an accredited school of Nursing.
  • Minimum of three (3) to five (5) years’ experience in clinical setting demonstrating the ability to assess, document, and implement the nursing care plan. Primary Care or Internal Medicine experience preferred.
  • Washington State Registered Nurse license. Basic Life Support (BLS) for Healthcare providers (AHA). A Washington State driver’s license and vehicle for work-related travel, required.

Keywords: Optum, Everett , RN Care Manager, Other , Everett, Washington

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