Remote Ambulatory RN Care Manager, CO

Optum

Apply Now

Requisition Number: 2196871
Job Category: Nursing
Primary Location: Boulder, CO
(Remote considered)

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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work.SM

The Ambulatory RN Care Manager 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!

As a member of the care team, the RN Care Manager will support continuous, comprehensive, coordinated care, with an emphasis on prevention, acute care follow-up, and chronic disease management for patient populations, including those patients who are most vulnerable.  The RN Care Manager is recognized as a key member of the patient care team within the family practice and internal medicine clinics. Specifically, the RN Care Manager provides health education to patients, assists patients with chronic disease self-management, coordinates referrals with specialists, and connects patients with appropriate care and community resources. The RN Care Manager coordinates and provides a patient-centered partnership with the patient care team to ensure a positive patient experience with care transitions. The RN Care Manager recognizes those patients with high health care utilization and works collaboratively within the care team to reduce unwarranted high-cost care.

If you reside in Boulder, CO, you will enjoy the flexibility of a hybrid-remote role as you take on some tough challenges.

Schedule: Monday to Friday 8:00am to 4:30pm; 2 days in clinic and 3 days remote

Primary Responsibilities:

  • Work cooperatively as a member of a care team with primary care providers, medical assistants, care coordinators, and other clinic staff to provide care to patients based on best practices and evidenced based medicine
  • Manage services for patients across the lifespan from newborn to geriatric
  • Provide nursing assessment and comprehensive health management to patients under longitudinal and episodic care management
  • Facilitate communication among care teams to address patient needs and barriers to care. Take immediate action to problem-solve when necessary
  • Review patient-centered goals to create and document a plan of care under provider’s guidance or established protocols. Elements of the care plan include treatment goals, patient goals, medication reconciliation, assessment of medication understanding and adherence, barriers to care, next steps, and follow-up plan
  • Develop and maintain trusting longitudinal relationships with patients and caregivers/family/significant other(s) while maintaining appropriate boundaries that are HIPAA compliant
  • Use clinical judgment in providing patient education and referrals for appropriate and timely care for referral in the community as necessary
  • Encourage patient self-management of chronic conditions
  • Facilitate transitions of care from hospitals, emergency room visits, urgent cares, and skilled nursing facilities. Provide timely follow-up including calling patients to reconcile medications, arrange appointments, assess understanding of discharge plan, and provide resources as needed
  • Update patient health records to reflect current condition, treatment plans, medications, etc. and remove outdated or lapsed conditions/medications. Assure services provided are consistent with the Joint Commission, ADAD and 27-10 regulations
  • Assess patient understanding of medications and adherence to medication regimen and address barriers to following treatment plan
  • Participate in quality improvement processes by identifying high-risk patients and implementing care plan (e.g., immunizations, screenings, medication adherence, diet, etc.)
  • Maintain knowledge of financial considerations and limitations of patient insurance coverage as appropriate
  • Support development and updates to a community resource directory and maintain a working relationship with providers in the referral network
  • Maintain working knowledge of health laws, protocols, managed care contracts, and insurance
  • Perform effectively in stressful and/or emergency situations and demonstrate knowledge and use of emergency procedures and equipment
  • Function as ambulatory clinic liaison, providing consultation/problem-solving between programs, medical staff, community professionals, and outside agencies
  • Cross cover for other clinical continuum teams in integrated clinical services: RN care manager, transitional care RN, and care coordinator
  • Performs all other related duties as assigned

What are the reasons to consider working for UnitedHealth Group?   Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

  • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
  • Medical Plan options along with participation in a Health Spending Account or a Health Saving account
  • Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
  • 401(k) Savings Plan, Employee Stock Purchase Plan
  • Education Reimbursement
  • Employee Discounts
  • Employee Assistance Program
  • Employee Referral Bonus Program
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
  • More information can be downloaded at: http://uhg.hr/uhgbenefits

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:

  • Associate’s Degree (or higher) in Nursing
  • Valid and unrestricted RN License (Colorado or compact state license)
  • Basic Life Support (BLS) Certification for healthcare providers required within 90 days of hire date
  • 2+ years of experience as an RN in a clinical setting
  • 2+ years of experience with medication reconciliation
  • 2+ years of experience working with Microsoft Office products including Outlook, Word, and Excel
  • 6+ months of experience working with an electronic medical record system

Preferred Qualifications:

  • 2+ years of experience in chronic disease management, case management, utilization management, or adult acute and chronic care management
  • 1+ years of experience coordinating patient care in an ambulatory setting
  • Understanding of motivational interviewing techniques or experience with health coaching
  • Knowledge of patient-centered care and the Patient-Centered Medical Home (PCMH) model of care as outlined by the National Committee for Quality Assurance
  • Knowledge of quality metrics and shared savings models
  • Understanding of the Primary Care First model
  • Well-developed oral and written communication skills
  • Ability to employ teach-back methods to assess patient understanding

Working Environment/Physical Activities:

  • Requires 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

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Colorado Residents Only: The salary range for Colorado residents is $56,300 to $110,400 per year. 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.