Ambulatory RN Care Manager - PT - Hybrid in Boulder, CO

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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

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 are located in Boulder, CO, you will have the flexibility to Work from home and the office in this hybrid role* as you take on some tough challenges.

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
• Serve on assigned committees
• Adhere to standard precautions as appropriate, which may include:
  • the use of protective barriers (e.g., gloves, masks, gowns, pocket masks, and/or safety glasses)
  • handling and disposing of infectious waste appropriately
  • hand washing

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:

• Valid and unrestricted R.N. license (Colorado or compact state license)
• Valid and unrestricted driver’s license
• Basic Life Support (BLS) for healthcare providers required within 90 days of hire date
• 2+ years as RN in clinical setting
• 2+ years of experience with medication reconciliation
• 2+ years working with Microsoft Office products: Outlook, Word, Excel
• Experience working with an electronic medical record system
• 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:

• 2+ years of experience in chronic disease management, case management, utilization management, or adult acute and chronic care management
• 1+ years of coordinating patient care in an ambulatory setting
• 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 Comprehensive Primary Care + model
• Understanding of motivational interviewing techniques or experience with health coaching
• Well-developed oral and written communication skills
• Ability to employ teach-back methods to assess patient understanding

Working Environment/Physical Activities:

• Requires full range of body motion including handling and lifting patients, manual and finger dexterity and eye-hand coordination
• Involves long periods of sitting, standing and walking
• 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

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. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

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

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.

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.