Per Diem Case Manager RN - Wisconsin

Explore opportunities with Optum , in strategic partnership withProHealth Care . ProHealth Care is proud to be a leader in healthcare services, serving Waukesha County and the surrounding areasfor more than a century. Explore opportunities across the fullspectrum of care as you help us improve the well-being of thecommunity with your skills, compassion and innovation. Be part of acollaborative environment that strives for excellence, nurturesrespect and ensures high-quality care delivery to our patients.Join us in making an impact as an Optum Team Member supporting ProHealth Care and discover the meaning behind Caring. Connecting.Growing together . The Case Manager RN is responsible andaccountable for coordination of patient services through aninterdisciplinary process, which provides a clinical andpsychosocial approach through the continuum of care. Throughconcurrent case management, patients will be assessed to determineappropriateness of admission, continued hospitalization, as well asappropriate level of care. Case Managers facilitate timely caredelivery at the right time, in the right setting, by following CMSguidelines, escalation of operational barriers, and collaborationwith all stakeholders. Discharge planning will begin at the time of(or prior to) admission, and reassessed ongoing throughout thecourse of hospitalization in partnership with the clinical team,the patient, and/or the patient's representative. Quality and RiskManagement issues will also be monitored and reported asappropriate. Locations: You will be asked to support any of thefollowing locations: Waukesha Memorial Hospital - 725 American Ave,Waukesha, WI Oconomowoc Memorial Hospital 791 Summit Ave.Oconomowoc WI 53066 Mukwonago Hospital 240 Maple Ave Mukwonago WI53149 Schedule: As needed/Per Diem, required to work 1 weekend amonth Training: We offer 2 weeks of paid training M-F standardbusiness hours Primary Responsibilities: Takes lead role indirecting disposition of patients and utilization considerationsAssumes leadership role to facilitate interdisciplinarycollaboration Effectively problem-solves and actively pursuesresolution Directly communicates with staff, physicians, patientsand families Role models leadership behavior through courtesy,respect and efficiency Coordinates patient care processes toachieve desired quality outcomes and identifies/controlsinappropriate resource utilization Facilitates patient and familyeducation and promotes continuity of care to achieve optimalpatient outcomes. Assures patient rights by offering a choice whenappropriate Reviews the patient plan of care with themulti-disciplinary team. Facilitates and participates inmulti-disciplinary team care conferences for patients with complexproblems. Communicates in the medical record and verbally with theteam to coordinate interventions and facilitate continuity of careDaily communication and collaboration with the patient care staffto provide continuous assessment, evaluation, and continuumplanning to assure the patient receives the appropriate level ofcare at the appropriate time Functions without direct supervision,utilizing time constructively and organizing assignments formaximum productivity. Arranges schedules to facilitate meetingswith physicians for patient care rounds, team meetings and otheropportunities to improve communication Ability to effectively read,write, and speak, cognitively process and emotionally supportperforming other duties as assigned Basic Microsoft Office SkillsAll employees are expected to remain flexible to meet the needs ofthe hospital, which may include floating to other departments toassist as patient needs fluctuate Must be able to functionallycoordinate and discharge plan for all age groups, including but notlimited to the unborn child through geriatric age groups The CMwill be responsible for integrating the assessment of the need forpost-hospital services and determination of an appropriatedischarge plan for complex cases Educates patient/family as tooptions/choices within the level of care determined to beappropriate. Initiates and ensures completion of all necessarypaperwork Facilitates completion of orders as required prior totransfer of patient to the next level of care in a timely manner sodischarge is not delayed Continuum of Care planning will emphasizeeducation and collaboration with physicians, family members,clinical social workers, nursing staff, therapists, and casemanagers from contracted payors when appropriate to determinedischarge plan that will be of maximum benefit to the patient.Involve staff from the next level of care in the treatment plan asearly as possible to promote continuity and collaboration Developcare plans for patients who frequent the Emergency Department inpartnership with the patient's physician, ED Provider, andcommunity resources Knowledge of all applicable federal and stateregulations. Shows working knowledge of managed care and Medicarehealth plans and reimbursement related to post-acute serviceswithin the continuum of care Reports all relevant information tothe staff assuming responsibility in the next level of careResponsible for communicating with the department director LOS andfinancial information, and issues that may affect the continuum ofcare process Adheres to name badge/dress code compliance What arethe reasons to consider working for UnitedHealth Group? Put it alltogether - competitive base pay, a full and comprehensive benefitprogram, performance rewards, and a management team whodemonstrates their commitment to your success. Some of ourofferings include: Paid Time Off which you start to accrue withyour first pay period plus 8 Paid Holidays Medical Plan optionsalong with participation in a Health Spending Account or a HealthSaving account Dental, Vision, Life& AD&D Insurance along withShort-term disability and Long-Term Disability coverage 401(k)Savings Plan, Employee Stock Purchase Plan Education ReimbursementEmployee Discounts Employee Assistance Program Employee ReferralBonus Program Voluntary Benefits (pet insurance, legal insurance,LTC Insurance, etc.) More information can be downloaded at: You'll be rewarded and recognized foryour performance in an environment that will challenge you and giveyou clear direction on what it takes to succeed in your role aswell as provide development for other roles you may be interestedin. Required Qualifications: Associate's Degree (or higher) inNursing Current, unrestricted RN license in the state of employment3 years of experience working in a hospital and inpatientmedical/surgical unit 3 years of experience working with inpatienthospital case management 3 years of experience with/knowledge ofcommunity resources, policies and procedures 3 years of clinicalexperience with/knowledge of age groups, including but not limitedto the unborn child through geriatric age group PreferredQualifications: Bachelor of Science Case Management CertificationMust have strong analytical, critical thinking and organizationalskills Knowledge of Utilization Review, Medicare Requirementsprocesses as well as State and Federal regulations pertaining toUtilization Review and Discharge Planning The salary range for thisrole is $ 28.61 to $ 56.06 per hour based on full-time employment.Pay is based on several factors including but not limited to locallabor markets, education, work experience, certifications, etc.UnitedHealth Group complies with all minimum wage laws asapplicable. In addition to your salary, UnitedHealth Group offersbenefits such as, a comprehensive benefits package, incentive andrecognition programs, equity stock purchase and 401k contribution(all benefits are subject to eligibility requirements). No matterwhere or when you begin a career with UnitedHealth Group, you'llfind a far-reaching choice of benefits and incentives. AtUnitedHealth Group, our mission is to help people live healthierlives and make the health system work better for everyone. Webelieve 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 goodhealth which are disproportionately experienced by people of color,historically marginalized groups, and those with lower incomes. Weare committed to mitigating our impact on the environment andenabling and delivering equitable care that addresses healthdisparities and improves health outcomes an enterprise priorityreflected in our mission. UnitedHealth Group is an Equal EmploymentOpportunity employer under applicable law and qualified applicantswill receive consideration for employment without regard to race,national origin, religion, age, color, sex, sexual orientation,gender identity, disability, or protected veteran status, or anyother characteristic protected by local, state, or federal laws,rules, or regulations. UnitedHealth Group is a drug - freeworkplace. Candidates are required to pass a drug test beforebeginning employment. RPO RED