Call Center Nurse RN, HouseCalls -Remote

At Optum, the integrated medical teams who practice within Home and Community Care are creating something new in health care. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be – helping patients access and navigate care anytime and anywhere. We’re connecting care to create a seamless health journey for patients across care settings. Join our team, it’s your chance to improve the lives of millions while Caring. Connecting. Growing together.

Optum is seeking a Call Center Nurse RN to join our HouseCalls team in Columbia, MD. Optum is a clinician-led care organization, that is creating a seamless health journey for patients across the care continuum. As a member of the broader Home and Community Care team, you’ll provide annual clinical assessments to patients in the comfort of their homes. This important preventive care helps identify and reduce health risks for patients, in addition to coordinating appropriate follow-up care to improve health and well-being. This team includes nurse care managers and social workers. The Nurse Care Manager (NCM) will report directly to the Manager/or Director of Clinical Operations of HCCST. The NCM interacts via telephonic consult with members and providers to assist with education and clarification on any concerns raised during the HouseCalls visit and ensure the member has/or assist in obtaining an appointment with the provider to transition care. They work to ensure members receive quality customer service by answering questions, addressing concerns, providing education, providing resource information, and entering referrals. The schedule is Monday through Friday from 9AM to 5:30PM Eastern or 9AM to 5:30PM Central respectively.

Perform telephonic outreach to members identified by the Advance Practice Clinician for specific referral related issues Ensure member has scheduled appointment with Primary Care Provider (PCP)/specialty provider; help scheduling appointment, if needed Refer members to internal departments such as Social Work, or Clinical Help Desk when appropriate Gather clinical information telephonically from patient/family Assist patients/members with urgent needs requiring acute intervention that arise during the call Identify triggers for hospitalization and barriers to meeting healthcare goals as they arise during the call Complete required documentation in compliance with auditing standards and policies Provide patient/family education on disease process and trigger management that arise during the call or are directly related to referral reasons Assist with connections to appropriate community resources if needed Understand and maintain confidentiality of legal and ethical issues Maintain compliance with all HIPAA (Health Insurance Portability and Accountability Act) regulations Enhance the experience of both internal and external customers by providing excellent customer service while maintaining production metrics Serve as a clinical resource and consultant for other clinicians Attend and participate in team huddles and staff meetings Work with Supervisor to identify system improvements that could be made to drive operational advancements and efficiencies Provide cross-coverage support across the team and assist with special projects, as needed Assume other duties as assigned and directed by the Supervisor or Manager of Clinical Call Center Operations