Are you ready for your next challenge? Discover it here at OptumCare and help us reinvent the health system. We're going beyond basic care, providing integrated health programs with a member-centric focus. The challenge is ensuring we deliver the right care at the right time. When you join us as a RN Nurseline Case Manager, you'll be making a difference in peoples' lives by offering telephonic support and assistance to members seeking health education, program referrals or general health services. You will work with patients to manage their health conditions for ultimate outcomes by taking in-bound calls and placing out-bound calls as dictated by consumer and business needs. What makes your clinical career greater with OptumCare? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. Whether in-person or over-the-phone, we're working to help others live healthier lives while providing an opportunity for you to do your life's best work.(sm) 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 Travel to physician offices, patient homes, SNF as needed
Required Qualifications:Current, unrestricted RN licensure 3+ years of Clinical RN experience 1 year of Case Management experience Ability to travel 70% of the time to our IPA / Vendor sites Intermediate computer skills (Microsoft Word, Outlook and Internet) with the ability to navigate a Windows environment Preferred Qualification:Bachelor's degree in Nursing Coaching and / or decision support experience Managed care or ambulatory care experience Strong inbound and outbound telephonic skills North American Medical Management, California, Inc. (NAMM California) partnered with OptumCare in 2012. NAMM California and OptumCare 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. 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: RN, Case Manager, CCM, embedded, acute care, ambulatory care, IPA, managed care, field, BSN, coaching, telephonic, Ontario, Moreno Valley, Riverside, CA, California
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.