Remote LVN, Case Manager

Optum

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Requisition Number: 2201759
Job Category: Nursing
Primary Location: Signal Hill, CA
(Remote considered)

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. 

Optum’s Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.

Under the direction of a Registered Nurse, this position is responsible for ensuring the continuity of care in both the inpatient and outpatient settings utilizing the appropriate resources within the parameters of established contracts and patients’ health plan benefits. Facilitates a continuum of patient care utilizing basic 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. Reports findings to the Care Management department Supervisor / Manager / Director in a timely manner.

If you are located in California, you will have the flexibility to work remotely* as you take on some tough challenges

Primary Responsibilities:

  • Consistently exhibits behavior and communication skills demonstrating Optum’s commitment to superior customer service, including quality, care, and concern with every internal and external customer
  • Implements current policies and procedures set by the Care Management department
  • Coordinates treatment plans and discharge expectations. Discusses DPA and DNR status with the attending physician when applicable
  • Prioritizes patient care needs. Communicates telephonically with patients, patients’ families, and caregivers as needed to discuss care and treatment plan
  • Identifies and assists with the follow-up of patients identified for high risk of readmission discharged from an acute care setting, observation setting, long term acute care, skilled nursing facilities, and custodial settings Consults with the physician and other team members to ensure that the care plan is successfully implemented
  • Coordinates provisions for discharge from facilities, including follow-up appointments, home health, social services, transportation, etc., to maintain continuity of care
  • Attends all assigned Care Management Committee meetings and reports on patient status as defined by the region
  • Maintains effective communication with the health plans, physicians, hospitals, extended care facilities, patients, and families
  • Provides accurate information to patients and families regarding health plan benefits, community resources, specialty referrals and other related issues
  • Maintains accurate and complete documentation
  • Identifies and refers patients to ambulatory care management programs, including HF, CLD, CCM, SW and Health Enhancement, to optimize clinical outcomes
  • Uses, protects, and discloses Optum patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

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:

  • Graduation from an accredited Licensed Vocational Nurse program
  • Current LVN license in California
  • 1+ years of recent clinical experience working as an LVN/LPN

Preferred Qualifications:

  • 3+ years of clinical experience working as an LVN/LPN
  • 2+ years of care management, utilization review or discharge planning experience
  • Experience in an HMO or experience in a Managed Care setting

California Residents Only: The hourly range for California residents is $19.47 to $38.08 per hour. 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.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy