RN, Case Manager
Company: Optum
Location: Torrance
Posted on: May 8, 2025
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Job Description:
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.
As a Registered Nurse, Case Manager, you will provide professional
nursing care by assessing, planning, implementing, and evaluating
the care of patients under the supervision of a clinician or RN,
Supervisor, or RN Charge Nurse. You will delegate tasks as needed
to professionals and para-professional employees. Coordinate
activities and works closely with clinicians and staff to maintain
efficient department functions and ensure the successful operation
of the department. You will be responsible for performing
operational duties as required under the supervision of the site
administrator or designer. Lastly, you will need to be familiar
with the Model of Care and NCQA guidelines.
Primary Responsibilities:
Prioritize patient care needs upon initial visit and address
emerging issues
Meet telephonically with patients, families, and caregivers as
needed to discuss care and treatment plans
Identify and assist with the follow-up of high-risk patients in
acute care settings, skilled nursing facilities, and custodial and
ambulatory settings
Consult with the physician and other team members to ensure the
care plan is successfully implemented
Use protocols and pathways aligned with established disease and
care management programs to optimize clinical outcomes and minimize
unnecessary institutional care
Monitor and coach patients using motivational interviewing
techniques and behavioral change to maximize self-management
Oversee provisions for discharge from facilities, including
follow-up appointments, home health, social services,
transportation, etc., to maintain continuity of care
Work in coordination with the care team and demonstrates
accountability with patient management and outcome
Discuss Durable Power of Attorney (DPOA) and advanced directive
status with the patient and PCP when applicable
Maintain effective communication with physicians, hospitalists,
extended care facilities, patients, and families
Provide accurate information to patients and families regarding
available resources through health plan benefits, community
resources, and referrals
Participate actively in Monthly Case Management Department meetings
and daily huddles
Document pertinent patient information and Case Management Plans in
Electronic Health Records
Coordinate care with central departments on assigned patient
caseload, including inpatient, long-term care facilities, adult
family homes, and home health agencies
Demonstrate a thorough understanding of the cost consequences of
Case Management decisions through utilization reports and systems
such as Health Plan Benefits, CM dashboards and reports
Maintain concise and accurate documentation that supports effective
and efficient management of care plans to decrease Emergency and
hospital readmissions
Adhere to departmental policies and procedures
Use, protect, and disclose Optum patients' protected health
information (PHI) only following Health Insurance Portability and
Accountability Act (HIPAA) standards
Participates in training all new case managers
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 school of nursing
Active, unrestricted Registered Nurse license through the State of
California
1+ years of experience in a clinical setting or case management
Preferred Qualifications:
Bachelor of Science in Nursing, BSN
Telehealth certification
3+ years of experience working in acute care
1+ years case management, utilization review or discharge planning
experience
HMO experience
The hourly range for this role is $28.61 to $56.06 per hour based
on full-time employment. Pay is based on several factors including
but not limited to local labor markets, education, work experience,
certifications, etc. UnitedHealth Group complies with all minimum
wage laws as applicable. 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.
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.
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. -
Keywords: Optum, Catalina Island , RN, Case Manager, Executive , Torrance, California
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