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UnitedHealth Group RN Complex Case Manger - IPA in Englewood, Colorado

Opportunities with New West Physicians. Bring your passion for health care to New West Physicians in Colorado, a team committed to providing excellent service to every patient… every time. We’re not only one of the largest physician groups in Colorado with 21 offices throughout the Denver Metro area - we’re also part of Optum, a nationwide family of nearly 45,000 dedicated physicians working together to help people live their healthiest lives. That means we’re backed by the resources of a global health care organization working to help people live healthier lives and help make the health system work better for everyone. For four consecutive years, New West Physicians achieved Elite status - the highest ranking - in the America’s Physician Groups Standards of Excellence Survey. In addition, New West Physicians was selected as one of the 2017 Million Hearts® Hypertension Control Champions by the Centers for Disease Control and Prevention, and was the 2015 recipient of AMGA's National Acclaim Award recognizing high performing medical groups bringing the American health care system closer to the ideal delivery model: one that’s safe, effective, patient-centered, timely, efficient, and equitable. It’s all possible because of our highly qualified, board-certified family practice and internal medicine physicians, hospitalists, cardiologists, gastroenterologists, psychiatrists, endocrinologists, neurologists, physician assistants, nurse practitioners and more. If this sounds like the place for you, it’s time to take a closer look at New West Physicians and discover a path to your life’s best work.(sm)

The Complex Case Manager provides telephonic case management of our high-risk patients by targeting those with multiple comorbidities, frequent hospitalizations, readmissions, and ER visits and/or identified by the PCP as needing close case management interventions. The Complex Case Manager uses sound clinical judgement and managed care principles in the coordination of care. The focus of this position is to assure that appropriate interventions and resources are in place and work with the patient, family and provider to assess, develop, implement, coordinate and evaluate the appropriate plan of care.

Primary Responsibilities:

  • Encourages members to be accountable for their chronic conditions

  • Educate members to adhere to physician recommendations for preventative care and treatment

  • Perform initial and ongoing assessment of medical and psychosocial needs and develop measurable outcomes along with individualized plan of care

  • Assist in arranging appointments and referrals for community resources

  • Responsible for member identification and stratification for complex care management

  • Collaborates with provider and supports the provider-patient relationship

  • Provides accurate and timely documentation in EHR regarding plan of care and progress towards goals

  • Understanding the course, clinical implications, and trajectory of specific diseases

  • Identifying and targeting patients likely to benefit from intervention

  • Focuses on prevention and working toward resolution of barriers to self-management

  • Work collaboratively with the Medical Management team to troubleshoot difficult or complex cases

  • Assemble patient information packets. Keep paper record of all communication and intervention wit patients

  • Performs other duties as required

  • HIPAA Security Level: High access to systems / patient information

  • Supervisory Duties: None

  • Work Environment/Schedule: Office environment, some remote option. Full time Monday thru Friday 8 am to 5 pm

  • Must have the ability to push, lift, or pull objects up to 40 pounds, using proper body mechanics; requires sitting, standing, and general movement in the office

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:

  • Current unrestricted Colorado RN license

  • Case Management experience

  • Knowledge of organizational policies, regulations and procedures to administer patient care

  • Must be able to type and have the ability to navigate a Windows based environment

  • MS Excel

Preferred Qualifications:

  • BSN

  • RN with minimum of 3-5 years in acute care setting

  • Certified Case Manager (CCM)

  • Knowledge of Medicare Population Health program guidelines

Proof of immunity to vaccine-preventable diseases is an employment requirement.

© 2019 OptumCare. All rights reserved.

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both its owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine provided by the medical practices of any of their physicians.

Diversity creates a healthier atmosphere: OptumCare and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

OptumCare and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Case management, RN, managed care, healthcare, Colorado, CO

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