1+ months

Complex Care RN Case Manager $1500 Sign On Bonus

Las Vegas, NV 89101
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*$1500 Sign-On Bonus for External Candidates only*

Do you have compassion and a passion to help others?  Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)
Southwest Medical, part of OptumCare, is a multi-specialty group of physicians, Nurse Practitioners, and Physician Assistants consisting of over 300 providers, 21 medical health centers including six urgent care clinics, four convenient care centers, two lifestyle centers catering to older adults, an outpatient surgery center, home health, hospice and palliative care services, plus E-visits and online options via Now Clinic telemedicine technology. Southwest Medical offers patients compassion, innovation, and quality care throughout southern Nevada. Southwest Medical is headquartered in the greater Las Vegas, NV area.

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics / programs that are of interest. The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically. 
Primary Responsibilities:
  • Apply case management standards of practice to focus on effective care of high risk high need patients at a specific site
  • Serve as a patient advocate and resource and provide critical information and recommendations to the rest of the care team
  • Participates in assessment activities to develop individualized plans of care in coordination with patient, family and providers
  • Follows patient through various transitions of care to ensure that any gaps are identified and remedied and promote efficient health care delivery
  • Maintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomes
  • Works collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of care
  • Assist clinicians in implementing best practices for chronic care and disease management
  • Follow standard protocols, processes and policies to include but not limited to the following: Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designee
  • Making outbound calls to assess members' current health status
  • Identifying gaps or barriers in treatment plans
  • Providing patient education to assist with self-management
  • Interacting with Medical Directors on challenging cases
  • Coordinating care for members
  • Making referrals to outside sources
  • Coordinating services as needed (home health, DME, etc.)
  • Educating members on disease processes
  • Encouraging members to make healthy lifestyle changes
  • Documenting and tracking findings
  • Utilizing Milliman criteria guideline for patient care
  • Responsible for monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient's home
  • Demonstrated ability to perform case management activities
  • Demonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learning
  • Knowledge of UM and plan benefit designs
  • Ability to demonstrate knowledge of and apply those to the job function and responsibilities
  • Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
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.

Jobs Rated Reports for Registered Nurse

Posted: 2020-09-22 Expires: 2020-11-21

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Complex Care RN Case Manager $1500 Sign On Bonus

UnitedHealth Group
Las Vegas, NV 89101

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Registered Nurse
118th2018 - Registered Nurse
Overall Rating: 118/220
Median Salary: $70,000

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