Nurse Case Coordinator - Per Diem

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Nurse Case Coordinator (NCC) is part of a dynamic team which works in collaboration with Physician Advisors and other departments within Optum Physician Advisor Solutions (OPAS). The Nurse Case Coordinator uses the Optum Clinical Group guidance (OCG) provided in order to ensure defensible and accurate case recommendationhss for concurrent admission, continued stay, and concurrent denial cases which are then reviewed by a Physician Advisor for completion of the concurrent and/or peer t peer review. They works directly with the Physician Advisors utilizing the guidance provided in order to make defensible and accurate case recommendations They coordinate key clinical findings, identifies high and low risks and proposes an initial case recommendation, supporting the clinical stay and/ or supporting a case through the concurrent denial process. They verify the accuracy and thoroughness of their work prior to sending the case to a physician for final review and case completion. The case is then submitted to a Physician Advisor for review completion. The Nurse Case Coordinator will maintain quality and productivity expectations. The Nurse Case Coordinator provides frontline customer service to clients and works in collaboration with other departments to ensure continuity of client care and satisfaction.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

The Nurse Case Coordinator accurately and efficiently reviews case details from patient records focusing on key elements according to process and following the OCG guidance. They completes cases in accordance with set productivity and quality expectations. The Nurse Case Coordinator performs job functions adhering to Optum Physician Advisor Solutions policies and procedures, which include but are not limited to the following:
OPAS clinical database/clinical data entry

• Will enter clinical information in the company's database as defined by the company policies and procedures
• Will maintain proficient knowledge of the database and/or programs utilized by NCC and other departments as needed
• Will promptly report any issues with the database and/or programs utilized by NCC to IT and the supervisory staff as needed
• Case Processing
  • Will accurately and efficiently review clinical data from the patient records focusing on key elements and obtain additional information as needed for case review completion
  • Will complete cases according tthe OCG guidance provided accurately
  • Will verify the accuracy and thoroughness of both concurrent and denial reviews prior to submitting the cases to an internal Physician Advisor for final review and case completion
• Productivity and Quality expectations
  • Will complete the minimum per case per hour/per day productivity requirements.
  • Will maintain or exceed quality expectations
  • Will participate in productivity and quality review meetings upon request from their direct supervisor
  • Will report any issues which may impact productivity or quality their direct supervisor
  • IT issues, ISP issues etc
• Interdepartmental collaboration
  • Will work in collaboration with other departments tensure minimum case data is provided to complete reviews as defined by OPAS processes

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:

• Unrestricted Registered Nurse License in your state of residence
• 3+ years working as a clinician in an acute care setting with good knowledge of hospital workflow preferred: Working in the Medical-Surgical, Emergency Department or Intensive Care Unit setting
• Advanced level of experience with MS Office Suite applications and software, internet navigation and utilization.
• Proficient typing skills
• Demonstrated ability to learn and understand various clinical software applications
• Proven solid clinical acumen

Preferred Qualifications:

• Demonstrated ability to stay focused on the detail
• Demonstrated organization
• Demonstrated collaborative skills and ability to interact with people of different backgrounds
• Proven solid written and verbal communication skills
• Demonstrated ability to use good judgment, deductive reasoning, and problem-solving abilities
• Proven self-motivated and able to function in a fast-paced work environment

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $xx.xx to $xx.xx per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group 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.

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