Manager, Regional Care Management - RN - Commerce, CA
Optum
Application
Details
Posted: 17-May-23
Location: Commerce, California
Salary: Open
Categories:
General Nursing
Internal Number: 121097576
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)
Responsible for providing expert clinical and administrative leadership to teammates within a given department or multiple departments to ensure efficiency of operations and functions. Under the supervision of a clinician, this teammate is responsible for ensuring that all policies and procedures are followed related to patient clinical care and safety. Responsible for performing operational duties as required under the supervision of the Lead clinician, site administrator or designee.
Primary Responsibilities:
Consistently exhibits behavior and communication skills that demonstrate Optum’s commitment to superior customer service, including quality, care and concern with each and every internal and external customer
Closely monitors patient safety at all times (i.e. does not leave patient on an exam table unattended) and participates in Optum fall prevention program
Complies with Optum sharps safety program at all times (i.e. only using devices with safety features and employing safe work practices)
Ensures appropriate staffing levels by scheduling on a daily and monthly basis within budgetary guidelines
Ensures compliance in licensing, certification and competencies
Evaluates nursing competencies and nursing decisions according to current nursing practice
Mentors and trains teammates in collaboration with the Site Administrator, lead clinician and people services department
Functions as a resource and serves as a liaison between administration, clinicians, teammates, other departments, patients and vendors
Provides direct patient care as needed
Participates in Nursing Leadership, Nurse Peer review and other committees as needed
Identifies and participates in quality improvement projects for the site
Conducts monthly teammate meetings to evaluate departmental needs and to communicate operational updates
Maintains clinical standards outlined in the clinical operations policies and procedures manual. Identifies deficiencies and recommends changes
Participates in educational programs to enhance nursing and management knowledge
Uses, protects, and discloses Optum patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Anticipates the needs of the Primary Care Physician (PCP) and carries out orders
Checks Electronic Health Records (EHR) for patients' arrival status and escorts patients from waiting area to exam rooms
Assists clinician and teammates in responding to patient emergency situations as per Emergency Response Protocols
Transports dirty equipment, performs appropriate cleaning, disinfecting, autoclaving, cold sterilization, maintains autoclave, cidex and A-test logs as needed
Ensures monthly expiration logs for medications and sample medications (refrigerated and non-refrigerated) are maintained
Instructs patient on lab, radiology, and other procedure / testing preparations
Participates in visit closure with patient and clinician by explaining next steps for lab, X-ray, referrals, Durable Medical Equipment (DME), etc.
Escorts patients to ancillary services when needed
Facilitates the transfer of pertinent patient information between site and referred Specialists, Hospitals, Urgent Care Centers, Ancillary Testing Facilities, etc.
Forwards all pre-op information to hospital surgeon
Schedules appointments
Registers new patients and refers them to the Eligibility department as needed
Ensures the "No shows" are entered into IDX, and performs "No Show" follow up process
Works bump list
Maintains immunization records and updates EHR (including California Immunization Registry (CAIR))
Assists with the completion of appropriate forms (DMV, disability, etc.)
Updates patient demographic information in IDX
Performs patient record audits
Answers, directs, and follows up on incoming calls
Calls patients as requested by clinician
Distributes incoming correspondence (faxes, consult notes, test results, etc.).
Participates in handling patient concerns, forwards form to the Patient Liaison or supervisor and responds to patient complaints if appropriate
Completes Care Team compliance measures on a daily basis (department specific)
Assists with Quality Metrics, Comprehensive Health Assessment Programs (CHAPS) formally HCC research, telephone call procedures, and patient follow up procedures
Participates in preparing department for internal and external site audits (facility site reviews) from SCAN, DHS, etc.
Interacts with the Patient Support Center, Eligibility department and Pharmacy Support Center
Participates in teammates / clinician “huddles”
Participates regularly in site teammates and department meetings
Covers teammate positions as needed
May assists with site marketing activities (i.e. health fairs, senior Olympics, flu clinics and other events)
Conducts pre and post-operative teaching for the patient, taking into account all psychological, physiological and religious aspects
Works in collaboration with a clinician to prepare, monitor and discharge patients after a procedure
Cleans and stocks exam and procedure/surgery rooms
Serves as a relief for the teammates
Assists with all departments specific functions within the RN scope of practice
Ensures monthly expiration logs for medications and sample medications (refrigerated and non-refrigerated) are maintained
Ensures yearly expiration logs for Preventative Maintenance (PM) are performed as needed
Ensures EKG reconciliation is performed and confirmed EKG’s are seen by clinician before patient is discharged
Ensures referral tickler file / log are maintained
Ensures immunization records and updating EHR (including California Immunization Registry (CAIR)) are performed
Participates in all Nursing Leadership regional meetings and Nurse Peer Review as needed
Conducts monthly teammate meetings to evaluate departmental needs and to communicate operational updates
Participates in verifying medications and vaccine doses for non-licensed teammates
Mentors and trains teammates in collaboration with the Site Administrator, lead clinician and people services department
Completes all mandatory online clinical education as assigned by clinical educators and immediate supervisor
Obtains, interprets, records and reports vital signs (temperature, pulse, respiration and blood pressure), height, weight, and other pertinent patient information to clinician
Develops an appropriate nursing care plan
Implements a plan of care by performing nursing interventions and assisting with procedures
Instructs patient on procedural preparations
Administers medication and other therapeutic modalities within the scope of practice of a Registered Nurse
Collects, labels and transports various specimens to appropriate destinations
Performs patient and family teaching
Documents and maintains records of medical and nursing procedures
Coordinates with clinicians and ancillary departments to plan daily work assignments according to teammates abilities, clinician and patient schedules, patient flow and procedures
Ensures adequate levels of supplies are maintained
Ensures that all equipment is maintained
Performs comprehensive patient assessment and triaging
Directs patients to appropriate levels of care and authorizes outside services
Notifies pharmacies of new prescriptions and authorizations of refills as ordered by clinician
Participates in educational programs to enhance nursing knowledge
Adheres to standard precautions at all times
Adheres to safety policies and procedures at all times
Uses, protects, and discloses Optum patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Frequently monitors overdue orders and follows approved process to address the orders
Assists with Meaningful Use (MU) initiative by encouraging patients to sign up for Follow My Health (FMH), obtaining patient’s email addresses, updating smoking status, and other initiatives
Assists clinicians with medication reconciliation per guidelines
Uses approved standing orders to perform, order test and update referrals
Assists with entering referrals in electronic health records EHR for clinician to authorize
Enters medical billing charges for services rendered in EHR
Participates in verifying medications and vaccine doses for non-licensed teammates
Mentors and trains teammates in collaboration with the Site Administrator, lead clinician and people services department
Attends in all mandatory Clinical Teammate Orientation (CTO) (both instructor led and online courses), Annual Clinical Updates, and Skills validation including those that could be held after working hours including the weekend
Participates in facilitation of annual skills validation for Medical Assistants take place during evening hours and or weekends (selected Saturdays only)
Ensures all Patient Intervention Reports (PIR) have been reviewed and actions taken
Assists clinician and licensed nursing teammates in responding to patient emergency situations as per Emergency Response Protocols
Verifies that the informed consents for procedures have been signed, dated and witnessed
Assists with Quality Metrics, Comprehensive Health Assessment Programs (CHAPS) formally HCC research, telephone call procedures, and patient follow up procedures
Prepares labels, collects and transports various specimens to appropriate destinations
Cross trainings to work in other departments or other duties as assigned by supervisor /management
Performs additional duties as assigned
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:
Bachelor’s degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college preferred
Graduate from an accredited school of Nursing
Current California RN license
3+ years of leadership experience (supervisor and above) with direct reports
Intermediate level of experience with Microsoft Suite
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Preferred Qualifications:
Master's degree or demonstrated equivalent experience
Supervisory experience
Ambulatory care experience
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.