From Home Prior Authorization Rn Jobs in Ohio (NOW HIRING)

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 talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The primary role of the Home Infusion Nurse is to provide clinical care and education to home-based patients receiving a wide range of parenteral medications dispensed from Optum Infusion Pharmacy (the "Company"). The most common route of administration is intravenous, however medications may also be given via subcutaneous infusion or injection, intramuscular injection, or intraspinal (intrathecal and epidural) infusion. Service delivery takes place in patient homes and also in ambulatory infusion suites, where available. All infusion services and medication delivery is provided in accordance with Optum Infusion Pharmacy policies, procedures and therapy-specific protocols, and based on comprehensive orders received from a physician or licensed practitioner. The Home Infusion Nurse fills an integral role in the clinical operations of the organization, working collaboratively with the multi-disciplinary team needed to prepare, deliver and seek reimbursement for the infusion therapy that is safely and effectively administered to each patient.

Coverage Area

This position will support the Cleveland/ West Toledo area.

Primary Responsibilities

• Establish and maintain positive clinical rapport with patients and their families, working closely with them in the provision of infusion therapy, education related to self-care and self-administration, and clinical monitoring of patient response to therapy
• Assess patient appropriateness for home infusion therapy, including safety of the home environment, availability of caregiver support, and willingness of patient and/or caregivers to become as independent in therapy administration and monitoring of response to therapy as possible
• Obtain and document patient's medical history at the start of care and ongoing, particularly as related to the diagnosis being treated with the prescribed infusion therapy
• Complete all required clinical documentation thoroughly and timely, including nursing plans of care (POC), plans of treatment (POT), visit notes, clinical summaries, medication profiles, discharge summaries and any updates provided to members of the patient's care team, as well as obtaining patient and/or caregiver signatures on relevant consents and required forms
• Participate in case conferences as needed to comprehensively plan patient care with the multi - disciplinary care team
• Provide skilled care to patients of varying ages and medical conditions, as outlined in the plan of care and in accordance with physician orders and the plan of treatment
• Establish, secure and maintain vascular access devices as prescribed, including (but not limited to) peripheral IV (PIV) placement, PICC and tunneled central venous catheter dressing changes, and implanted port access
• Administer medications as prescribed, performing therapy-specific clinical assessments in accordance with the Company's policies, procedures and protocols, which may include frequent vital sign monitoring, management of acute infusion reactions, monitoring of side effects, and procurement of laboratory specimens
• Communicate observations of patient response to therapy and overall physical assessment/condition with members of the care team in a timely manner, which may include the nursing supervisor, dispensing pharmacist, registered dietitian, and licensed prescriber, among others
• Establish collaborative relationships with home health agencies (HHAs) delivering services on behalf of / or in conjunction with the Company, providing agency education and support as requested by the nursing supervisor
• Maintain a comprehensive knowledge base of infusion therapies administered in the home and ambulatory infusion center, utilizing Company policies, procedures and protocols in addition to all available training resources to ensure understanding of each therapy before initiating treatment
• Maintain current nursing licensure in all states in which patients are serviced, as required by the respective State Boards of Nursing and/or Department of Health
• Comply with all State and Federal regulations and laws, including employee health and safety protections mandated by the Occupational Safety and Health Administration (OSHA), patient privacy and data security required by the Health Insurance Portability and Accountability Act (HIPAA), as well as all home infusion standards of practice
• Complete all training required upon hire and annually per policy, including cardiopulmonary resuscitation (CPR) certification
• Serve as a professional representative of the Company when meeting with and/or providing education to external customers, payers and referral sources
• Assist in staff orientation and training, serving as a clinical educator and resource as requested
• Drive personal/rental vehicle (per travel policy) in the completion of job duties, including (but not limited to) travel to the Company office, patient homes, area hospitals, physician offices, home health agency offices, and the Company's Ambulatory Infusion Suite (AIS)

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

• Active and unrestricted licensure as a Registered Nurse (RN) in the state(s) of practice and others as requested
• Current Basic Life Support (BLS) and/or CPR certification, or willing to obtain prior to starting employment
• 1+ years of experience working as an RN in a clinical care setting that contributes to proficiency in infusion therapy (such as medical surgical unit, emergency department, intensive care unit, post-anesthesia care unit, or similar setting)
• Active, unrestricted driver's license with low infractions (you will be driving rental vehicles)
• Proficient with electronic medical record documentation
• Willing and able to work with an interdisciplinary team of professionals including pharmacists and technicians, physicians and other licensed prescribers, registered dietitians, home health agencies (HHAs), sales representatives, and others as needed to provide comprehensive care and support of patients and caregivers
• Willing and able to work independently in home or alternate-site settings
• Willing and able to assume a flexible work schedule
• Willing and able to meet attendance, overtime, after-hours on-call, and other reliability requirements of the position
• Driver's license and access to reliable transportation that will enable travel to customer and/or patient sites

Preferred Qualifications

• Experience administering infusion therapy in a home or alternate-site setting
• Knowledge of and experience with Microsoft Office and electronic medical records (EMR) programs
• Knowledge of the Infusion Nursing Society (INS) standards of practice, policies and procedures
• Knowledgeable of HIPAA patient privacy and data security requirements, OSHA employee protection regulations, and The Joint Commission's accreditation standards for home health and home infusion pharmacy (or other relevant accrediting organizations)
• Proficient with Microsoft Office
• Proven excellent organizational and critical thinking skills
• Proven effective interpersonal communications, both written and verbal
• Proven effective teaching skills

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 $29.00 to $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.