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UnitedHealth Group OptumCare Case Management (CM) RN Supervisor - Phoenix, AZ in Phoenix, Arizona

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 and help people live healthier lives while doing your life's best work. (sm)

OptumCare Network of Arizona is a network of health care providers in the Southwest, whose mission is to connect and support providers by working together to deliver the most effective and compassionate care to each and every patient they serve. OptumCare Network of Arizona is focused doing the right things for patients, physicians, and the community. OptumCare Network of Arizona’s Core Business is contracting directly with health insurers to deliver a highly personal care management and service model to their patients. The current focus of OptumCare Network of Arizona is on seniors, and those with complex care needs, who most benefit from a high touch model of care.

The Case Management (CM) RN Supervisor supports the CM team by providing leadership, overseeing the day-to-day operations, and assisting with program development to ensure the objectives of the program are met.

Primary Responsibilities:

  • Provides clinical guidance and support to assigned CMs and other staff

  • Assists in the hiring, orientation, training, and retention of CMs and other staff

  • Performs oversight of CM caseloads and makes adjustments as needed for effective case management

  • Assists in process improvement efforts for OptumCare AZ

  • Regularly audits or oversees the audits of the CM team’s documentation on patient assessments

  • Accountable for defined outcomes and metrics associated with the case management processes

  • Serves as the clinical liaison and collaborates with OptumCare AZ vendors and community partners

  • Maintains audit tools of CM programs

  • Facilitate the use of community resources to mitigate return to acute of our members / beneficiaries

  • Facilitate monthly team meetings

  • Manage the patient survey response process and contact members as requested

  • Coordinating Interdisciplinary team rounds and other projects

  • Prepare productivity and performance reports for department and leadership meetings

  • Ensures standardized execution of workflow processes, policy and procedure, auditing, etc.

  • Manages case managers’ assigned case load

  • Act as a resource for direct reports to include inquiries and assistance as needed

  • Advocating and facilitating members / beneficiaries with coordination of care issues, as needed

  • Other assigned duties

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 RN license in the state of AZ

  • Bachelor’s degree in nursing (BSN)

  • 1+ years of leadership experience

  • 3+ years of experience in an acute care setting

  • Experience using EMR, utilization management and / or prior authorization systems

  • Knowledge of case management, quality improvement, and coordination of care

  • Possess planning, organizing, conflict resolution, negotiating and interpersonal skills

  • Experience with Microsoft Office

  • CCM certification, if does not have certification, must obtain within 2 years of hire

  • Independent problem identification / resolution and decision making skills

  • Able to prioritize, plan, and handle multiple tasks / demands simultaneously

  • Access to reliable transportation that will enable you to travel to client and / or patient sites within Phoenix ( West Valley).

Preferred Qualifications:

  • Experience working with Medicare members

  • Experience managing a field based team

  • Working knowledge of hospice and palliative care

  • Graduate degree in related field

OptumCare® Network of Arizona and Network of Utah are patient-centered groups working to support health plans with a top network of medical clinicians and hospitals that offer comprehensive care. We give patients the tools and resources to maintain their health and enjoy the activities that they love. We also offer transition programs that support patients leaving the hospital or skilled nursing facility and care Management programs that help patients with complex health problems get care in the comfort of their own homes.

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 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 by the medical practices or any of their physicians.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Case Manager, RN, Supervisor, BSN, CCM, utilization, Phoenix, AZ, Arizona

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