Senior RN Complex Case Manager - Optum NV
Company: Optum
Location: Boulder City
Posted on: May 16, 2025
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Job Description:
$10,000 Sign On Bonus for External Candidates
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Optum NV is seeking a Senior RN Complex Case Manager to join our
team in Las Vegas, NV. 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. Here, you'll work alongside talented peers in a
collaborative environment that is guided by diversity and inclusion
while driving towards the Quadruple Aim. 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.
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The Senior Case Manager will identify, coordinate, or provide
appropriate levels of care under the direct supervision of an RN or
MD. Function is responsible for clinical operations and medical
management activities across the continuum of care (assessing,
planning, implementing, coordinating, monitoring and evaluating).
This includes case management, coordination of care, and medical
management consulting. Function may also be responsible for
providing health education, coaching and treatment decision support
for members. -
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Primary Responsibilities:
Applies motivational interviewing in identifying impact on member
engagement and setting goals
Member education, medication reconciliation and benefit
management
Ensures follow through with the Care Navigation Team; timely
appointments and referrals to programs, health plan and
community
Facilitate patient/family and provider communications as indicated
and advocate for patient/family with healthcare team as needed
Ensures coordinated services delivered and available programs are
accessed
Communicate with stakeholders, appropriate health care related
information to ensure timely coordination care and services for
members currently receiving inpatient care
Utilizes approved clinical criteria to asses and determine
appropriate level of care for members currently receiving inpatient
care
Identified point of contact for managing transitions of care
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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:
Current, unrestricted NV RN license
3+ years of direct patient care nursing with a focus on discharge
planning or case management
Proven knowledge of UM and plan benefit designs
Proven knowledge of Utilization review and MCG -
Competent with MS Office and other practice management systems or
possess the ability to continue to learn new things
Access to reliable transportation that will enable you to travel to
client and/or patient sites within a designated area
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Preferred Qualifications:
CCM certification
Solid clinical knowledge and capacity for continued learning
Proficient in critical thinking skills of RN Case manager
Proven ability to organize and prioritize tasks for self and
patients
Proven solid verbal and written communication skills
Proven ability to perform case management activities
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The salary range for this role is $71,600 to $140,600 annually
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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Diversity creates a healthier atmosphere: OptumCare is an 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.
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OptumCare is a drug-free workplace. Candidates are required to pass
a drug test before beginning employment.
Keywords: Optum, Ontario , Senior RN Complex Case Manager - Optum NV, Executive , Boulder City, California
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