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Complex care case management seeks to provide thoughtful, tailored nursing support to patients across a spectrum of illnesses of varying severity and progression. Our patients may be anywhere along a continuum from adjusting to a “new normal” all the way through to transitioning to hospice care. Many of our patients dealing with serious illness benefit from assistance in understanding their medical reality. Therefore, this position integrates palliative approaches to care in our primary care setting. This role works closely with physicians, social workers, other specialty teams (like palliative care, oncology, etc.) to ensure coordinated and value-concordant care. In addition, CM RN will work closely with colleagues in local hospitals, SNFs, and hospices. RN CM will participate in multi-disciplinary team meetings to coordinate an iterative plan of care for our most complex, high-risk patients, as well as those dealing with natural decline. This complex work benefits from a nursing approach that is focused on creative problem solving and big-picture awareness rather than short-term solutions and reliance on strict rubrics.

Position in this function provides physicians and other health care professionals with appropriate care management tools, support, education and information to enable real time clinical decision-making. Delegates specific tasks of plan of care to Medical Assistants and Health Coaches and oversees the plan of care to ensure protocols are followed and desired outcomes are achieved. Practices within the scope of nursing rules and regulations as established by the Washington Department of Health. Complies with all reporting requirements, including operational protocol submittals. Provides effective care management across the care continuum and suggests and implements methods to improve cost effectiveness and quality of care.

Primary Responsibilities:

• Care Management activities include early identification of high-risk patients, concerted planning involving physicians and mid-level practitioners, monitoring of services provided by outside physicians, home health, DME, and other providers; monitoring emergency department use as well as identifying opportunities to decrease emergency department utilization and other elements of care utilization

• Provides effective care management across the care continuum, including coordination involving internal and external providers of care, families and other entities, as appropriate

• Works in collaboration with colleagues in multiple care settings to determine patients’ barriers and needs utilizing clinical skills and independent decision making

• Engages in proactive, concurrent care management for patients with chronic or complex medical conditions

• Performs visits to patient home, skilled nursing home stays or while in-patient at a neighboring hospital

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:

• Graduation from an accredited school of nursing

• Active Registered Nurse license through the Washington State Department of Health

• 2+ years of professional nursing experience

• Knowledge of medical terminology and managed care

• Washington State driver’s license and automobile

Preferred Qualifications:

• Case management certification

• Ambulatory and inpatient experience

• Knowledge of ICD and CPT coding

• Knowledge of professional nursing theory and practice to assess, plan, implement and evaluate patient care

• Knowledge of organizational policies, regulations and procedures to administer patient care

• Knowledge of medical equipment and instruments, common safety hazards, and precautions to establish a safe work environment

• Knowledge of relevant resources within the organization and community

Washington Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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 .

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.