Care Manager at Optum Kissimmee

UnitedHealth Group - Kissimmee, FL

Full-time - Entry Level

Onsite - Kissimmee, FL

Insurance Carriers and Related Activities

About the position

The Care Manager at Optum is responsible for ensuring continuity of care for patients in both inpatient and outpatient settings. This role involves utilizing advanced nursing knowledge and skills to facilitate patient care, coordinate treatment plans, and ensure quality outcomes. The Care Manager works closely with the care team and primary care providers to implement care plans and support high-risk patients, while also adhering to established protocols and guidelines.

Responsibilities

• Exhibit superior customer service and communication skills with all internal and external customers.
• Represent the company professionally, adhering to all policies and procedures.
• Protect and disclose patients' protected health information (PHI) in accordance with HIPAA standards.
• Obtain CPR certification within 90 days of employment.
• LPNs must obtain IV Certification within 90 days of employment.
• Prioritize patient care needs during initial visits and address emerging issues.
• Meet with patients, families, and caregivers to discuss care and treatment plans.
• Identify and assist with follow-up for high-risk patients in various care settings.
• Consult with physicians and team members to ensure successful implementation of care plans.
• Coordinate treatment plans and triage interventions among team members.
• Utilize protocols and pathways to optimize clinical outcomes.
• Monitor and coach patients using motivational interviewing techniques.
• Oversee discharge provisions and follow-up appointments to maintain continuity of care.
• Maintain effective communication with physicians, patients, and families.
• Provide accurate information regarding plan benefits and community resources.
• Document pertinent patient information in Electronic Health Records and FOCUS.
• Understand cost consequences of Care Management decisions through utilization of reports and systems.
• Adhere to departmental policies and procedures approved by relevant committees.
• Collaborate with providers and care teams to carry out nursing interventions.
• Perform additional duties as assigned.
• Travel as necessary or cover centers remotely based on business needs.

Requirements

• High school graduate, GED or equivalent.
• Graduation from an accredited school of Nursing.
• RNs must have an Associate's or Bachelor's degree in Science.
• LPNs must have IV Certification.
• Current and valid LPN or RN Florida state license.
• Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross).
• Experience in an acute clinical care setting or equivalent.
• Care management, utilization review, or discharge planning experience.
• Knowledge of current standards of patient care.

Nice-to-haves

• Bachelor's degree in Nursing.
• 1+ years of experience in an acute clinical care setting.
• HMO experience.

Benefits

• $2,500 Sign On Bonus for LPNs.
• $5,000 Sign On Bonus for RNs.