North American Medical Management, California, Inc. (NAMM California) partnered with OptumHealth in 2012. NAMM California and OptumHealth share a common goal of bringing patients, physicians, hospitals and payers closer together in the mission to increase the quality, efficiency and affordability of care. NAMM California is a part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. NAMM California develops and manages provider networks, offering a full range of services to assist physicians and other providers in supporting patient care coordination and their managed care business operations. For over 18 years, NAMM California has been an innovator in health care with a track record for quality, financial stability, extraordinary services and integrated medical management programs. NAMM California is well positioned to continually invest in its infrastructure and systems for the benefit of its provider clients and to accommodate the impending changes that will come forth from healthcare reform. The NAMM California provider clients represent a network of almost 600 primary care physicians and over 3,000 specialists and work with the premier hospitals in their respective markets. Primary Responsibilities:Provides health education and coaches consumers on treatment alternatives to assist them in best decision making Supports consumers in selection of best physician and facility to maximize access, quality, and to manage heath care cost Coordinates services and referrals to health programs Prepares individuals for physician visits Assesses and triages immediate health concerns Manages utilization through education Identifies problems or gaps in care offering opportunity for intervention Assists members in sorting through their benefits and making choices Takes in - bound calls and places out - bound calls as dictated by consumer and business needs Travel to local IPA and patient homes as needed
Required Qualifications:Current, unrestricted RN licensure 3+ years of hands-on clinical RN experience, preferably in ambulatory or inpatient setting 1+ year of Case Management experience Ability to navigate a Windows environment ( Word, Outlook and Internet) Access to reliable means of transportation to conduct field visits up to 75% of the timePreferred Qualifications: Bachelor's degree in Nursing Coaching and / or decision support - experience Experience working in complex care, managed care Experience working with Medicare population Previous experience working in the fieldCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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)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. Job Keywords: Case Manager, RN, Medicare, Managed care, Complex care, Field, ambulatory, inpatient, outpatient, Ontario, CA
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.