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OptumCare AZ - Medical Behavioral Integration RN Case Manager (field based) Phoenix, AZ job in Atlanta at UnitedHealth Group

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OptumCare AZ - Medical Behavioral Integration RN Case Manager (field based) Phoenix, AZ at UnitedHealth Group

OptumCare AZ - Medical Behavioral Integration RN Case Manager (field based) Phoenix, AZ

UnitedHealth Group Work From Home Full Time

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's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

The Optumcare Medical Behavioral Integration Nurse Case Manager (MBI NCM) is a direct clinical liaison between OptumCare/Care Delivery organization customers and the clinical network.   This position integrates a collaborative process which assesses plans, implements, coordinates, monitors and evaluates options and services to meet the member’s health needs, using education, communication and all available resources to promote quality, cost-effective outcomes.

Primary Responsibilities:

  • Screens and identifies members with high-risk, long term chronic conditions who will benefit from care management services. Monitors utilization as needed. Referrals for cases may originate from various sources
  • Performs comprehensive assessments, identifies and assists members with high-risk symptoms/diagnoses and/or members with multiple co-morbidities who will benefit from intervention and engaging in care management services, information is collected from the patient, caregiver(s), health care providers and other relevant parties as needed
  • Document’s findings and develops individualized careplans in a concise/comprehensive manner compliant with documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations
  • Utilizes advanced clinical skills to make effective decisions to meet the member’s health, behavioral health and psychosocial needs, providing coaching, patient education, communication, and all available resources to promote quality and cost-effective outcomes
  • Documents patient/family status, diagnosis, medications, treatment plan, goals, interventions, evaluation results, observations and progress in electronic medical record/proprietary database in a timely and accurate manner
  • Advocates for members and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team
  • Integrates a collaborative approach by attending interdisciplinary team meetings with nurses, physicians and patient care coordinators regarding patient care as needed
  • Collaborates with providers to determine acuity of behavioral health concerns and refer members to appropriate community resources
  • Utilizes professional knowledge and critical thinking skills to facilitate MD consultation on complex and/or complicated cases
  • Applies Nursing/Counseling/Social Work theory, knowledge, professional ethics, methods, and interventions to improve member health and psychosocial functioning within the scope of licensure and job function
  • Manages assigned case load in an efficient and effective manner

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:

  • RN with 2+ years of experience
  • AZ RN License must be active and unrestricted
  • 2+ years of experience in a related field-based case management 
  • Proficient computer skills and good working knowledge of Microsoft Word
  • Experience handling sensitive issues with members and providers in a confidential manner according to HIPAA guidelines
  • Demonstrated initiative in achieving individual, team, and organizational goals and objectives

Preferred Qualifications:

  • Medical/Behavioral setting experience (i.e. hospital, managed care organization, or joint medical/behavioral outpatient practice)
  • Dual diagnosis experience with mental health and substance abuse
  • Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients
  • Experience working with low-income populations
  • Experience working with the aged, blind or disabled
  • Clinical training experience
  • Excellent customer service skills
  • Excellent interpersonal and problem-solving skills
  • Solid team player and team building skills
  • Solid interpersonal skills
  • Able to function independently and responsibly with minimal supervision
  • Maintain direct and open communication with all levels of the organization
  • Ability and flexibility to assume responsibilities and tasks in a constantly changing work environment
  • Solid oral and written communication skills - specifically telephone skills

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

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.

Job Keywords:  Registered Nurse, RN, case manager, case management, managed care, telephonic, health care, healthcare, Tucson, AZ, field-based CM

 

Recommended Skills

  • Assessments
  • Behavioral Medicine
  • Case Management
  • Clinical Works
  • Coaching And Mentoring
  • Consulting
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