Onsite RN Care Manager - Hybrid
Company: Optum
Location: Riverside
Posted on: May 8, 2025
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Job Description:
For those who want to invent the future of health care, here's
your opportunity. We're going beyond basic care to health programs
integrated across the entire continuum of care. Join us to start
Caring. Connecting. Growing together. -
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Optum's Pacific West region is redefining health care with a focus
on health equity, affordability, quality, and convenience. From
California to Oregon and Washington, we are focused on helping more
than 2.5 million patients live healthier lives and helping the
health system work better for everyone. At Optum Pacific West, we
care. We care for our team members, our patients, and our
communities. Join our culture of caring and make a positive and
lasting impact on health care for millions.
Schedule: Mon - Fri; 8-5pm
Department: Inpatient Concurrent Review
Locations: On site - Redlands Community Hospital -
On-Site Schedule: Hospital Census dependent: 3 Days/Week or 5 Half
days with In-Person Rounds
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Position in this function is responsible for providing professional
nursing care by assessing, planning, implementing, and evaluating
the care of patients under the supervision of a clinician or RN,
Supervisor, or RN Charge Nurse. Delegates tasks as needed to
professionals and para-professional employees. Coordinates
activities and works closely with clinicians and staff to maintain
efficient department functions and ensure the successful operation
of the department. Responsible for performing operational duties as
required under the supervision of the site administrator or
designee. Familiar with the Model of Care and NCQA guidelines.
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Primary Responsibilities: -
Prioritizes patient care needs upon initial visit and addresses
emerging issues
Meets in person or telephonically with patients, patients'
families, and caregivers as needed to discuss care and treatment
plan
Identifies and assists with the follow-up of high-risk patients in
acute care settings, skilled nursing facilities, custodial and
ambulatory settings
Consults with the physician and other team members to ensure that
the care plan is successfully implemented
Uses protocols and pathways in line with established disease
management and care management programs to optimize clinical
outcomes and minimize unnecessary institutional care
Monitors and coaches patients using motivational interviewing
techniques and behavioral change to maximize self-management
Oversees provisions for discharge from facilities, including
follow-up appointments, home health, social services,
transportation, etc., to maintain continuity of care
Works in coordination with the care team and demonstrates
accountability with patient management and outcome
Discusses Durable Power of Attorney (DPOA) and advanced directive
status with patient and PCP when applicable
Maintains effective communication with the physicians,
hospitalists, extended care facilities, patients and families
Provides accurate information to patients and families regarding
resources available to them through health plan benefits, community
resources, and referrals
Participates actively in Monthly Care Management Department
meetings and daily huddles
Documents pertinent patient information and Care Management Plan in
Electronic Health Record
Coordinates care with central departments on assigned patient
caseload, including inpatient, long-term care facilities, adult
family homes, and home health agencies
Demonstrates a thorough understanding of the cost consequences
resulting from Care Management decisions through utilization
reports and systems such as Health Plan Benefits, CM dashboards and
reports
Maintains concise and accurate documentation that supports
effective and efficient management of care plans to decrease
Emergency and hospital readmissions
Adheres to departmental policies and procedures. Uses, protects,
and discloses HCP patients' protected health information (PHI) only
in accordance with Health Insurance Portability and Accountability
Act (HIPAA) standards
Participates in training all new care manager
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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, unrestricted Registered Nurse license through the State of
California
1+ years of experience in a clinical setting or care management
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Preferred Qualification: - -
Bachelor of Science in Nursing, BSN
Telehealth certification
3+ years of experience working in acute care
1+ years of previous care management, utilization review or
discharge planning experience
HMO Experience
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The hourly range for this role is $23.70 to $46.35 per hour based
on full-time employment. 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.
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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. - -
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OptumCare is an Equal Employment Opportunity employer under
applicable law and qualified applicants will receive consideration
for employment without regard to race, national origin, religion,
age, color, sex, sexual orientation, gender identity, disability,
or protected veteran status, or any other characteristic protected
by local, state, or federal laws, rules, or regulations. -
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OptumCare is a drug-free workplace. Candidates are required to pass
a drug test before beginning employment -
Keywords: Optum, Riverside , Onsite RN Care Manager - Hybrid, Executive , Riverside, California
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