[Hiring] RN Care Coordinator or Care Manager ED - Supervisor @UnitedHealth Group

Role Description

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Optum Health is seeking an experienced ED Nurse Supervisor to join our growing engagement efforts. This role will provide management and supervision for the ED RN Case Management team tasked with monitoring real-time ‘Admit, Discharge, Transfer’ (ADT) notifications to provide proactive ED outreach and discharge coordination to support optimal transitions of care.

• Provides supervision and leadership support to the nurses on the ED RN Case Management team.
• Ensures effective delivery of workflows for each facility, and the accurate documentation and entering of information to support program KPIs and clinical visibility.
• Supports development and maintenance of nursing workflows, staffing levels and schedules to ensure operations efficiency, quality, and financial performance.
• Assumes escalation support when additional case intervention is needed.
• Recruits, trains, monitors, and educates the nursing staff on job duties.
• Performs duties of an ED RN Care Coordinator/Care Manager.
• Evaluates and measures outcomes to continuously improve workflows and team productivity.
• Fosters teamwork and strengthens a culture of continuous improvement.
• Ensures performance is tracked accurately utilizing internal tools and processes (e.g., dashboards; scorecards; reports).
• Provides input on resolution of barriers affecting program.
• Work in this role impacts multiple markets and sites at a national scale.

Clinical Leadership:

• Collaborates with Medical Directors, ED Physicians, and other clinical stakeholders.
• Maintains clinical standards aligned with operations policies and procedures.
• Performs relevant clinical reviews at designated facilities.
• Supports operations team by providing patient-level case reviews for market reports.
• Leads clinical recruitment, onboarding, training, education, and compliance with licensure requirements.

Program Management:

• Educates RNs on monthly metrics, glidepaths, goals and improvements.
• Aligns RNs workflows to market-specific targets (i.e., quality metrics, disease-specific programs, Hospital at Home, and vendor-based services).
• Facilitates recurring RN staff meetings to communicate operational updates.
• Works with Program Manager to update RN training materials, guides, and knowledge base.

RN Supervision:

• Mentors and provides supervision and leadership support to the ED RN Case Management team.
• Coordinates with operations teams to assign and manage RN placements by market.
• Completes all RN scheduling, coverage plans, and appropriate staffing levels.
• Ensures effective development and delivery of facility workflows by the CM team.
• Manages RN escalations in collaboration with deployment teams and hospital stakeholders to resolve patient, program, and facility issues.
• Monitors timely and accurate documentation into designated applications to comply with documentation requirements.
• Supports RNs in acquisition and maintenance of required systems (ADT, EMR, CM platforms).
• Communicates organizational objectives and vision to the team.
• Develops RN performance goals and tracks performance throughout the year for effective RN development and engagement.

Case Management:

• Participates in educational programs to enhance nursing and management knowledge.
• Uses, protects, and discloses Optum patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Performs ED Care Coordinator/Care Manager duties to keep updated with workflows and as required for coverage.
• Collaborates effectively with ED and outpatient care teams to establish an individualized transition plan for members.
• Identifies member’s ED discharge support opportunities level of risk by monitoring real-time ADT feeds and communicates with patient, ED, and outpatient teams for discharge coordination.
• Conducts transition of care outreach following ED discharge to confirm access and completion of discharge plan.
• Enters timely and accurate documentation into designated applications to comply with documentation requirements.

Qualifications

• Degree in nursing combined with 4 or more years of clinical experience.
• Current, unrestricted RN license.
• 2+ years in nursing supervision/leadership role.
• Experience working in the ED.
• Knowledge of care coordination, utilization management, quality improvement, and discharge planning.
• Knowledgeable in Microsoft Office applications including Outlook, Word, and Excel.
• Proven ability to read, analyze and interpret information in medical records, and health plan documents.
• Proven planning, organizing, conflict resolution, negotiating and people skills.
• Proven ability to utilize critical thinking skills, nursing judgement, and decision-making skills.
• Proven ability to prioritize, plan, and manage multiple tasks/demands simultaneously.

Requirements

• Leadership experience managing a group of nurses.
• General knowledge of clinical programs, provider relations and customer service.
• Working in a tight-knit team environment with diverse professional groups.
• Proven ability to build a high performing team by promoting a culture of energy and commitment, mentoring employees, and supporting ongoing training and development of staff.
• Proven ability to successfully operate in a changing environment.
• Proven ability to manage multiple priorities and deadlines in an expedient and decisive manner.
• Demonstrated solid appetite for learning.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution (all benefits are subject to eligibility requirements).

Company Description

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.

OptumCare 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.

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