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Job Details

UnitedHealth Group

Senior Programs Nurse Coordinator - Hybrid in Ontario, CA




Ontario, California, United States

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)

The Senior Program RN will be a member of the Senior Programs Care Management team coordinating ACT services for our senior members, linking community services, coordinating benefits through insurance carriers, coaching, encouraging and educating members to participate in programs. Collecting data for program reports. Assisting the Director with vendor relationships and vendor oversight.

If you are located in Ontario, CA, you will have the flexibility to telecommute*, as well as work in the office as you take on some tough challenges.

Primary Responsibilities:

  • Supports the vision and direction of the company and medical management department
  • Using professional judgement and critical thinking skills to assist with program evaluations
  • Outreach calls to members to coordinate senior programs
  • Create a positive experience and relationship with members
  • Collects data for clinical review and data reporting
  • Participate in weekly vendor IDT Meetings
  • Build relationships with PrimeCare PCP’s
  • Facilitates patients appointments as directed by the case manager
  • Assist with care coordination for High Risk Senior Members identified on the Optum One High Risk List
  • Monitors daily census and monthly ER reports to identify changes in health status
  • Communicates health status changes to the clinical staff for re-assessment of care plan
  • Communicates with patients and caregivers to address barriers
  • Provides feedback to Program Director regarding process improvement
  • Assist program manager with vendor relationships and management with goal of ensuring sufficient resources and ability to provide service
  • Assist in training and orientation to staff members for all supportive programs
  • Performs data entry
  • Prepares tracking reports
  • Identifies and escalates urgent clinical issues proactively and effectively to licensed clinical staff in order to avoid Emergency Room visits or other complications by patients
  • May travel to IPA provider offices to meet with patients as indicated by licensed staff
  • Coordinates services through contracted ancillary providers, health plan partners, and other community agencies as indicated
  • Other duties as assigned

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:

  • High School diploma or equivalent
  • Bachelor of Science in Nursing, Associate Degree in Nursing or Diploma Degree in Nursing
  • Valid California Driver’s license and insurance
  • 5+ years clinical nursing experience
  • Social services or community relations experience
  • Knowledge of managed care principles as it relates to Case Management processes
  • Knowledge of Health Plan compliance requirements
  • Knowledge of medical terminology
  • Knowledge of community resources
  • Computer literate in Microsoft Word and Excel
  • 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:

  • 1+ years of experience working with Seniors
  • Bi-lingual Spanish written and verbal fluency skills
  • Flexible, well organized, self-starter and team player
  • Ability to develop innovative approaches in delivering health care and social services to assist member in maintaining independence or slow disease progress
  • Excellent verbal and written communication skills
  • Strives to continually improve processes and relationships with team, providers, physicians, vendors and members
  • Solid ability to work effectively with nurses, physicians and other clinical and operational staff, both written and verbally
  • Self motivated with strong organizational skills
  • Ability to look at challenges as opportunities
  • Flexible and adaptable of schedule to attend various meetings and/or promotional events
  • Ability to read quickly with excellent comprehension and retention

Working Environment:

  • Normal office environment. May be subject to temperature variations in the office. Occasional early morning, evening or weekend work. Occasional pressure due to multiple tasks, deadlines, high inpatient census, calls or interruptions.

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)

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

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.