Care Manager Optum Starkey
Optum
Date: 6 hours ago
City: Largo, FL
Contract type: Full time
$2,500 Sign-on Bonus for LPN External Candidates / $5,000 Sign-on Bonus for RN External Candidates
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
Positions in this function is responsible for ensuring the continuity of care in both the inpatient and 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 or telephonically as the need arises. Works in conjunction with the care team and PCP as care team leader. Ensures evaluation is in alignment with site based goals.
Primary Responsibilities
Required Qualifications
**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.
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
Positions in this function is responsible for ensuring the continuity of care in both the inpatient and 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 or telephonically as the need arises. Works in conjunction with the care team and PCP as care team leader. Ensures evaluation is in alignment with site based goals.
Primary Responsibilities
- 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 as delineated in Transitions of Care program
- Identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings
- Uses protocols and pathways in line with established disease management and care management programs and approved by medical management in order to optimize clinical outcomes
- Oversees provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc., in order to maintain continuity of care
- Maintains effective communication with the physicians, disease management, hospitalists, extended care facilities, patients and families
- Demonstrates a thorough understanding of the cost consequences resulting from Care Management decisions through utilization of reports and systems such as Health Plan Benefits, utilization of metrics and CM reports
Required Qualifications
- High school graduate, GED or equivalent
- State Licensed LPN or RN
- Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross) or be able to obtain within 90 days of employment
- Additional Requirements for LPNs: Certificate in Practical Nursing
- Valid Florida LPN license
- IV certification or the ability to obtain within 90 days of employment
- Additional Requirements for RNs:
- Associates or Bachelor’s degree in Science
- Valid Florida RN license
- 1+ experience in an acute clinical care setting
- Care management, utlization review or discharge planning experience
- HMO experience
- Ability to read, write and speak the Spanish language fluently
**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.
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