Hedis Rn Jobs in Nevada (NOW HIRING)

$10,000 Sign-on Bonus for External Candidates

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

The Clinic Case Manager is responsible for fostering collaboration and a team approach for successfully supporting patients with high-risk health conditions to navigate the healthcare system. Promote empowerment by facilitating the role of an educator, resource, and advocate for patients and their families to ensure a maximum quality of life. Interacts and collaborates with multidisciplinary care teams, to include physicians, nurses, pharmacists, case managers, social workers, and other educators. Works in a less structured, self-directed environment and performs all delegated nursing duties within the scope of a RN license of the applicable state board of nursing.

Ensures compliance to contractual and service standards as identified by relevant health insurance plans. Adheres to policies, procedures, and regulations to ensure compliance and patient safety. Participation in Compliance and required training is a condition of employment.

Primary Responsibilities:

• Role embedded within the primary care clinic, working directly with patients, clinical and non-clinical teams providing transitional case management services
• Performs assessment/screening of health conditions; Collaboration with the member, caregiver(s), clinician(s), and/or other appropriate healthcare professionals to address need and goals
• Pursues appropriate interventions to reduce risk of condition exacerbation, ER and hospitalization utilization to meet department/organization metrics or goals
• Supports transition of care from Emergency Department or inpatient stay to outpatient setting. Assist with referrals (home health/DME) and appointments (PCP/specialist)
• Achieves Quality Measures outcomes via reduction in HEDIS Gaps in Care

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:

• Valid NV RN License
• Current BLS Certification or willingness to obtain within 3 months of hire
• 2+ years of job-related experience in an acute care setting
• Knowledge of medical terminology; nursing assessment and follow up on patient's needs
• Proven skilled with MS Office software applications and electronic medical records (EMR)
• Proven excellent communication, interpersonal, organization and customer service skills
• Positive personality and willingness to effect change
• Proven ability to multi-task and work under pressure
• Valid NV State Driver's license and access to reliable transportation

Preferred Qualifications:

• Bachelor's degree or higher in nursing
• 3+ years of experience providing hospital care (ICU/Floor) or Emergency room (ED) nurse or case management within Hospital/Clinic/Practice

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 salary for this role will range from $72,800 to $130,000 annually 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.

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.