Optum

posted 3 months ago

Full-time - Entry Level
Insurance Carriers and Related Activities

About the position

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. As a team member of our Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing. This life-changing work adds a layer of support to improve access to care. In this role, you will ensure accurate and complete documentation, communicate and collaborate with the interdisciplinary care team, and assist the provider/team with various care coordination activities. You will also assist the provider/team with benefit determination associated with Medicare part A, part B, and part D benefits. Collaborating with the primary advanced practice clinician (APC) and facility to identify and respond to patient changes in condition is a key responsibility. Additionally, you will assist the provider/team with therapy coordination and participate in facility-based meetings. Your responsibilities will include scheduling and participating in family conferences, team meetings, and team case presentations, as well as coordinating training, tracking, and compliance with quality measures. You will assist in creating and conducting in-services for selected audiences and help providers ensure complete and accurate documentation and coding, medication reconciliation, nursing rounds, assessment, and patient documentation. You may also write verbal orders from the provider in the chart in compliance with state RN practice laws and individual nursing facility practices. Furthermore, you will assist in managing members through acute medical situations or exacerbations of chronic conditions, including testing, diagnostics, and interventions, and help manage members during short-term sub-acute rehabilitation episodes.

Responsibilities

  • Ensure accurate and complete documentation
  • Communicate and collaborate with the interdisciplinary care team
  • Assist the provider/team with various care coordination activities
  • Assist the provider/team with benefit determination associated with Medicare part A, part B, and part D benefits
  • Collaborate with the primary advanced practice clinician (APC) and facility to identify and respond to patient changes in condition
  • Assist the provider/team with therapy coordination
  • Participate in facility-based meetings
  • Schedule and participate in family conferences, team meetings, and team case presentations
  • Coordinate training, tracking, and compliance with quality measures
  • Assist in creating and conducting in-services for selected audiences
  • Assist providers in assuring complete and accurate documentation and coding, medication reconciliation, nursing rounds, assessment, and patient documentation
  • Write verbal orders from the provider in the chart in compliance with state RN practice laws and individual nursing facility practices
  • Assist in managing members through acute medical situations or exacerbations of chronic conditions, including testing, diagnostics, and interventions
  • Assist in managing members during short-term sub-acute rehabilitation episodes

Requirements

  • Associate degree or higher in Nursing (RN)
  • Active and unrestricted license in the state which you reside, or ability to obtain by start date
  • Certified in Basic Life Support
  • 3+ years of clinical experience in practice
  • Proven ability to complete physical requirements, including lifting a 30-pound bag and ability to perform physical assessment
  • Access to reliable transportation

Nice-to-haves

  • Experience in meeting the medical needs of patients with complex behavioral, social and/or functional needs
  • Understanding of geriatrics and chronic illness
  • Proficient computer skills including the ability to document medical information with written and electronic medical records
  • Proven ability to work with diverse care teams in a variety of settings
  • Proven effective communication skills and time management

Benefits

  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution
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