Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. This is a Per Diem position working Monday, Wednesday, and Thursday - 6 hours a day. During flu season - October - January. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: • Identify relevant internal policies and regulatory guidelines • Ensure compliance with clinical guidelines • Attend Flu preparation meetings with EOHS and all MPPS for instructions for the upcoming 2025/26 Flu season • Work in Flu/Covid system - Solutions for Enterprise Safety & Health (SESH), under Immunizations for Validation Review monitoring EE uploads of flu documentation. Review and approve valid Flu and Covid documentation. Those not approved, supply reason so employees can correct and re-post to the Cority site for approval • Track all flu documentation, exemptions, declines for all MPPs, using Teams/Flu/Exemptions Tracking sheet • For those EEs declining the flu vaccine, send out forms via email - Flu Program FAQ, Religious Exemption Form and/or Medical Exemption Form • Send exemption emails with the above exemption forms to those employees who have declined • NLH-send only medical exemption as religious exemptions not accepted • All other MPPs send both medical/religious and FAQ Flu • Ensure Medical exemptions forms have provider checking box stating employee is a patient and has contraindication to the flu vaccine and provider signature and date • Monitor exemption list for completion. Sending out email reminders for those non-compliant. Maintaining a non-compliant list and reaching out to PBPs to aid in compliance with those MPPs who have progressive discipline in place • Run weekly Power BI reports for updated list of complaints and non-compliant employees. Sending out email reminders • Find answers to basic questions and determine what other information could provide a more complete understanding of the situation • Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business results You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Optum Home & Community Care is part of UnitedHealth Group and provides telephonic case management services to help members navigate the health care system and access support services. As an RN Case Manager, you would assess members' health status, identify gaps in treatment plans, establish care goals, coordinate with multidisciplinary teams including mental health clinicians, provide patient education and coaching, make referrals to community resources, and facilitate transitions between care settings—primarily through phone calls in a high-volume customer service environment.
