ED Case Manager (RN)
Company: UnitedHealth Group
Location: Louisville
Posted on: September 18, 2023
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Job Description:
Optum is a global organization that delivers care, aided by
technology to help millions of people live healthier lives. The
work you do with our team will directly improve health outcomes by
connecting people with the care, pharmacy benefits, data and
resources they need to feel their best. Here, you will find a
culture guided by diversity and inclusion, talented peers,
comprehensive benefits and career development opportunities. Come
make an impact on the communities we serve as you help us advance
health equity on a global scale. Join us to start Caring.
Connecting. Growing together. -
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We are currently seeking an Emergency Department Case Manager (RN)
to join our team on a part-time basis that will consist of 8 hour
shifts totaling 48 hours per bi-weekly pay period, including 1
weekend shift). -This is an onsite based role that will be part of
a team that supports a deep strategic partnership between
OptumInsight and Boulder Community Health, a nationally recognized,
independent and community-focused health system that serves Boulder
County, Colorado, and beyond. Boulder Community Health has a
powerful vision - "partnering to create and care for the healthiest
community in America" and Optum is proud to be one of the partners
helping to advance that vision.
What we do: Optum provides managed services across a broad set of
functions for Boulder Community Health - including case management,
ambulatory care management, revenue cycle management, patient
access (scheduling and registration), analytics, project
management, and strategic transformation initiatives. Our aim is to
enable Boulder Community Health to retain its independence as a
community-focused health care provider, while providing access to
the support and scale of Optum's people, processes, and technology.
Come join us!
The Emergency Department Case Manager (RN) is responsible and
accountable for coordination of patient services through an
interdisciplinary process, which provides a clinical and
psychosocial approach through the continuum of care. - Through
concurrent case management, patients will be assessed to determine
appropriateness of admission, continued hospitalization, as well as
appropriate level of care. Discharge planning will begin at the
time of (or prior to) admission, and reassessed ongoing throughout
the course of hospitalization. - Quality and Risk Management issues
will also be monitored for and reported as appropriate.
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Primary Responsibilities:
Professional Accountabilities
Adheres to name badge/dress code compliance
Effectively problem-solves and actively pursues resolution
Directly communicates with staff, physicians, patients and
families
Role models leadership behavior through courtesy, respect and
efficiency
Coordinates patient care processes to achieve desired quality
outcomes and identifies/controls inappropriate resource
utilization
Facilitates patient and family education and promotes continuity of
care to achieve optimal patient outcomes. - Assures patient rights
by offering a choice when appropriate
Reviews the patient plan of care with the multi-disciplinary team.
- Facilitates and participates in multi-disciplinary team care
conferences for patients with complex problems. - Communicates in
the medical record and verbally with the team to coordinate
interventions and facilitate continuity of care
Daily communication and collaboration with the patient care staff
to provide continuous assessment, evaluation and continuum planning
to assure the patient receives the appropriate level of care at the
appropriate time
Functions without direct supervision, utilizing time constructively
and organizing assignments for maximum productivity. - Arranges
schedule to facilitate meeting with physicians for patient care
rounds, team meetings and other opportunities to improve
communication
Continuum of Care Planning
The CM will be responsible for integrating the assessment of the
need for post-hospital services and determination of an appropriate
discharge plan for complex cases
Educates patient/family as to options/choices within the level of
care determined to be appropriate. - Initiates and insures
completion of all necessary paperwork
Facilitates completion of orders as required prior to transfer of
patient to the next level of care in a timely manner so discharge
is not delayed
Continuum of Care planning will emphasize education and
collaboration with physicians, family members, clinical social
workers, nursing staff, therapists and case managers from
contracted payors when appropriate to determine discharge plan that
will be of maximum benefit to the patient. - Involve staff from
next level of care in the treatment plan as early as possible to
promote continuity and collaboration
Reports all relevant information to the staff assuming
responsibility in the next level of care
Employees are expected to comply with all regulatory requirements,
including CMS and Joint Commission Standards
Risk Management
Interface with department directors, Risk Management and patient
representatives to identify potential QA or risk issues. Perform
any necessary investigation, documentation and follow-up as
required
Participates in departmental SQI projects
Ability to functionally coordinate and discharge plan for all age
groups, including but not limited to the unborn child through
geriatric age groups
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You'll be rewarded and recognized for your performance in an
environment that will challenge you and give you clear direction on
what it takes to succeed in your role as well as provide
development for other roles you may be interested in. -Required
Qualifications:
Valid and unrestricted Registered Nurse (RN) license within the
State of Colorado
6+ months of experience in a healthcare or clinical setting
Ability to work on a part-time basis (8 hour shifts totaling 48
hours per bi-weekly pay period, including 1 weekend shift) in our
Boulder, CO facility
Solid communication skills are necessary for meeting facilitation,
educational presentations, team collaboration and patient
interviews
Solid analytical, critical thinking and organizational skills
Knowledge/understanding of community resources, policies, and
procedures
Preferred Qualifications:
Bachelor of Science in Nursing or Master's in Social Work
Case Management Certification
BLS Certification
Clinical knowledge of the Labor and Delivery, Neonatal, Medical
Surgical, Oncology, ICU patient and process
Working Environment/Physical Activities:
Normal visual acuity and hearing
Ability to work with patients at various levels of care
Ability to work with culturally diverse patients
Ability to write, dictate, or otherwise communicate within diverse
patient populations
Ability to hear normal-level conversations and recall/record
accurate information
Operate within designated work area to include frequent
communication over the telephone with patients, community resources
and other health professionals
Exposure to communicable diseases, toxic substances, ionizing
radiation, medicinal and other conditions common to a clinic
environment, including blood and body fluids
Accomplishes tasks while working under pressure of deadlines
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Careers with Optum. Our objective is to make health care simpler
and more effective for everyone. With our hands at work across all
aspects of health, you can play a role in creating a healthier
world, one insight, one connection and one person at a time. We
bring together some of the greatest minds and ideas to take health
care to its fullest potential, promoting health equity and
accessibility. Work with diverse, engaged and high-performing teams
to help solve important challenges. -
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Colorado Residents Only: The salary range for Colorado residents is
$56,300 to $110,400. Pay is based on several factors including but
not limited to education, work experience, certifications, etc. In
addition to your salary, UnitedHealth Group offers benefits such
as, a comprehensive benefits package, incentive and recognition
programs, equity stock purchase and 401k contribution (all benefits
are subject to eligibility requirements). No matter where or when
you begin a career with UnitedHealth Group, you'll find a
far-reaching choice of benefits and incentives.
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At UnitedHealth Group, our mission is to help people live healthier
lives and make the health system work better for everyone. We
believe everyone-of every race, gender, sexuality, age, location
and income-deserves the opportunity to live their healthiest life.
Today, however, there are still far too many barriers to good
health which are disproportionately experienced by people of color,
historically marginalized groups and those with lower incomes. We
are committed to mitigating our impact on the environment and
enabling and delivering equitable care that addresses health
disparities and improves health outcomes - an enterprise priority
reflected in our mission. - - - -
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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. -
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UnitedHealth Group is a drug - free workplace. Candidates are
required to pass a drug test before beginning employment. -
Keywords: UnitedHealth Group, Denver , ED Case Manager (RN), Executive , Louisville, Colorado
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