Case Manager RN -$5k sign-on bonus - Oklahoma City, OK

$5,000 Sign-on Bonus for External Candidates

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.

Coordinates systems and services with an organized, interdisciplinary team approach which delivers quality, cost-efficient care to patients through the continuum of healthcare services. Appropriateness of admission and continued stay reviews are conducted concurrently or retrospectively. Collaborates with the patient, families and other members of the healthcare delivery team to facilitate appropriate movement through the care continuum as demonstrated through quality outcomes. Works effectively with internal and external customers and proactively improves case management processes.

Work Schedule: Monday through Friday 8:00am-5:00pm-may need to cover weekend shifts depending on business needs

Primary Responsibilities:

• Comply with national and state compliance standards. Assess data to determine medical necessity and appropriateness of level of care and/or admission based on approved criteria with minimal direction Attend and actively participate in departmental, hospital and medical meetings as assigned
• Monitor utilization of resources and services in a quality conscious manner and in relation to covered services and length of stay parameters. Manage clinical and operational bottlenecks which impact the quality, length of stay and resource utilization and documents the results
• Refer all questionable utilization cases to the phusician advisor and/or management for discussion and facilitate action plans. Prioritize caseload according to changes in the patient’s condition and the current and future care plans. Coordinate denial of benefits notice with physician, business office and patient/family
• Promote safe, competent discharge planning using philosophy, policies, procedures, and standards of care of various disciplines to include departmental and national standards. Participate through multidisciplinary rounds and team conferences and meetings with patients/families and healthcare team members
• Collaborate with the patient/family and multidisciplinary staff to develop and adjust care protocols, treatment goals and discharge goals
• Serve as a resource and hospital liaison to patients/families, physicians, the healthcare team, and external organizations, in regards to the case management program, available healthcare resources, appropriate level of care and financial issues
• Perform other related duties as assigned that correspond to the overall function of this position

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:

• Associate Degree - Nursing
• Registered Nurse (RN) - State of Oklahoma
• 2 + years clinical experience in healthcare as a registered nurse with demonstrated experience.
• 1 + years of case management experience
• 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 Qualification:

• Bachelor’s degree in Nursing

Physical Requirements:

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs
• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors
• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry
• Occasional bending, stooping, kneeling, squatting, twisting and gripping
• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs
• Rare climbing

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.

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.