Optum UT is seeking a Skilled Nursing Facility (SNF) Case Manager to join our team in Draper, UT. 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. 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 in improving healthcare through the power of people and intelligent technologies while Caring. Connecting. Growing together. The Skilled Nursing Facility (SNF) Case Manager is responsible for coordinating and managing care for Medicare Advantage members admitted to skilled nursing facilities. This role collaborates with facility staff, providers, members, caregivers, and interdisciplinary teams to support safe transitions of care, improve member outcomes, reduce avoidable hospital readmissions, and promote appropriate skilled nursing facility length of stay through proactive care coordination and case management interventions. This position serves as a key liaison between the health plan, facility partners, providers, members, and caregivers to ensure timely, effective, and member-centered care. The SNF Case Manager plays a critical role in mitigating financial and quality risks to the organization. Candidate must live and possess an active and unrestricted Utah RN license If you are located in the state of Utah, you will have the flexibility to work remotely* as you take on some tough challenges. Position Highlights & Primary Responsibilities: • Manage a caseload of Medicare Advantage members admitted to skilled nursing facilities • Develop, implement, and monitor individualized care plans based on member needs, goals, and available resources • Collaborate with SNF staff, physicians, advanced practice providers, therapists, caregivers, and interdisciplinary teams to coordinate care and support positive outcomes • Participate in interdisciplinary care conferences and discharge planning meetings • Monitor member progress toward established goals and identify opportunities to improve quality, efficiency, and member experience • Facilitate safe transitions between care settings, including discharge to home, assisted living, community-based services, or other appropriate levels of care • Collaborate with Community Health Workers and interdisciplinary team members to address social determinants of health and barriers impacting care • Complete documentation accurately and within established timelines and regulatory requirements • Maintain knowledge of Medicare guidelines, post-acute care services, community resources, and care management best practices • Comply with all organizational, regulatory, privacy, and compliance requirements • Facilitate timely primary care, specialty care, and post-discharge follow-up appointments • Maintain accurate, timely, and complete documentation in accordance with organizational, regulatory, and accreditation requirements • Adhere to all applicable policies, procedures, HIPAA regulations, and quality standards • Participate in performance improvement, care coordination, and population health initiatives designed to improve member outcomes and reduce healthcare utilization • Perform other duties as assigned 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.
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.
