Optum
At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.
Optum NY, (formerly Optum Tri-State NY) is seeking a RN Case Manager to join our team in Poughkeepsie, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone. This position is mostly remote, with attendance to the Poughkeepsie, NY office as required for onsite meetings or training. This is high volume, customer service environment. You’ll need to be efficient, productive and thorough dealing with our members over the phone. Solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes.
Required Qualifications: Registered Nurse licensed to practice in New York State (NYS) with current NYS registration and in good standing 3+ years of diverse clinical experience; preferred in caring for the acutely ill members with multiple disease conditions Experience and proficiency working with electronic medical records Remote telephonic experience Knowledge of utilization management, quality improvement and discharge planning Knowledgeable in Microsoft Office applications including Outlook, Word and Excel Preferred Qualifications: Bachelor of Science in Nursing (B.S.N.) Certified Case Manager (CCM) Experience with Complex Case Management and NCQA requirements
Make outbound calls and receive inbound calls to assess members’ current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self-management Make referrals to outside sources Provide a complete continuum of quality care through close communication with members via telephonic interaction Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels
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