Compassion is the essential trait that drives superior health care performance. But it's just a start. At OptumCare innovative thinking is just as important. Our unique team of health care providers are an emerging and important part of Optum and the UnitedHealth Group family of businesses. Our approach is designed to help physicians and other providers deliver the right care at the right time in the right setting. That takes smart ideas and incredible teamwork. And that's where you come in. In this role, you'll support a clinical team that's helping patients in new and better ways while giving them a generous helping of compassion and respect. This position integrates a collaborative process which plans, implements, coordinates, monitors and evaluates options and services to meet the member's holistic health needs, using education, communication and all available resources to promote quality, cost-effective outcomes. This is a full time, Monday-Friday position. The RN must be able to travel within assigned territory / location area to conduct critical face to face assessments. Territory Assignments are based on business needs. Applicants must be willing to carry a diverse clinical caseload and visit the patient in their home, hospital, SNF,etc... Primary Responsibilities: - Screens and identifies members with high-risk, long term chronic conditions who will benefit from care management services. Monitors utilization as needed. Referrals for cases may originate from various sources - Performs member evaluations and onsite visits as needed in multiple settings, including but not limited to: telephonic, member's homes, PCP/Specialists clinic, hospital, and skilled nursing facilities and provides feedback on planned interventions and outcomes of the plan of care - Performs comprehensive assessments, identifies and assists members with high-risk symptoms/diagnoses and/or members with multiple co-morbidities who will benefit from intervention and engaging in care management services, information is collected from the patient, caregiver(s), health care providers and other relevant parties as needed - Documents findings and develops individualized careplans in a concise/comprehensive manner compliant with documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations - Utilizes advanced clinical skills to make effective decisions to meet the member's health, behavioral health and psychosocial needs, providing coaching, patient education, communication, and all available resources to promote quality and cost-effective outcomes - Documents patient/family status, diagnosis, medications, treatment plan, goals, interventions, evaluation results, observations and progress in electronic medical record/proprietary database in a timely and accurate manner - Advocates for members and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team - Integrates a collaborative approach by attending interdisciplinary team meetings with nurses, physicians and patient care coordinators regarding patient care as needed; Collaborates with providers to determine acuity of behavioral health concerns and refer members to appropriate community resources - Utilizes professional knowledge and critical thinking skills to facilitate MD consultation on complex and/or complicated cases - Applies Nursing/Counseling/Social Work theory, knowledge, professional ethics, methods, and interventions to improve member health and psychosocial functioning within the scope of licensure and job function - Manages assigned case load in an efficient and effective manner - Performs all other related duties as assigned 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 UT - 3+ years of clinical experience in an acute care, home health, hospice, geriatric, behavioral health and / or hospital setting - Experience using EMR and CM practice guidelines - Knowledge of discharge planning alternatives options and interdisciplinary approaches - Able to handle sensitive issues with members and providers in a confidential manner according to HIPAA guidelines - Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area (up to 75% of the time in the field) 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. *PLEASE NOTE* The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus. 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. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.