Senior RN Case Manager- Complex Case Management

$10,000 Sign On Bonus for External Candidates

Optum NV is seeking a Senior RN Case Manager - Complex Case to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

The Senior Case Manager is responsible for identifying, coordinating, and facilitating appropriate levels of care across the continuum of care. This role oversees clinical operations and medical management activities, including assessing, planning, implementing, coordinating, monitoring, and evaluating patient care plans. The Senior Case Manager will regularly meet with patients in their homes to conduct assessments, support care coordination, provide education, and evaluate ongoing needs. Responsibilities also include case management, care coordination, medical management consultation, health education, wellness coaching, and treatment decision support to help members achieve optimal health outcomes.

Primary Responsibilities

• Applies motivational interviewing in identifying impact on member engagement and setting goals
• Member education, medication reconciliation and benefit management
• Ensures follow through with the Care Navigation Team; timely appointments and referrals to programs, health plan and community
• Facilitate patient/family and provider communications as indicated and advocate for patient/family with healthcare team as needed
• Ensures coordinated services delivered and available programs are accessed
• Communicate with stakeholders, appropriate health care related information to ensure timely coordination care and services for members currently receiving inpatient care
• Utilizes approved clinical criteria to asses and determine appropriate level of care for members currently receiving inpatient care
• Identified point of contact for managing transitions of care

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 intere

Required Qualifications

• Current, unrestricted NV RN license
• 3+ years of direct case management experience
• Competent with MS Office and other practice management systems or possess the ability to continue to learn new things
• Proven time management skills
• Access to reliable transportation with valid driver's license and car insurance that will enable you to travel to client and/or patient sites within a designated area

Preferred Qualifications

• BSN
• CCM certification
• Solid clinical knowledge and capacity for continued learning
• Proficient in critical thinking skills of RN Case manager
• Proven ability to organize and prioritize tasks for self and patients
• Proven excellent verbal and written communication skills
• Proven ability to perform case management activities

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.