***Hybrid Role in Columbus, OH and Hilliard, OH - This individual is responsible for working on site in a Columbus, OH or Hilliard, OH based office 2 days per week. ***
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 a culture guided by diversity and inclusion, 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.
When you join the Optum Care Network – Midwest team, you become part of a team that strives to identify and retain the top healthcare professionals in the markets it serves. The Population Health RN will be responsible for providing Case Management services for identified patients. The Population Health RN works directly with the patient, provider(s), facilities and other entities to ensure the most appropriate utilization of resources and coordination of care. The Population Health RN provides advocacy, communication and resource management to achieve quality and cost-effective outcomes.
This position will support two of Optum's American Health Network practices in Columbus. Candidate must reside in the Columbus, OH area and have the ability to work in office 2 days per week. Work locations for this position are listed below;
Schedule: Monday - Friday, 8:00am-5:00pm. No evenings, weekends or holidays.
If you reside in the Columbus, OH or Hilliard, OH area and have the ability to work in office 2 days per week, you will have the flexibility to work remotely* as you take on some tough challenges.
- Assesses the healthcare, educational, and psychosocial needs of the patient and their family at the initial referral to case management
- Designs individualized plan of care with the patient and develops a team approach by working collaboratively with the family, primary care provider and other members of the healthcare team to ensure coordination of services
- Monitors and updates individualized plan of care for the patient using a team approach by working collaboratively with the family, primary care provider and other members of the healthcare team to ensure coordination of services
- Implements clinical interventions based on evidence based clinical guidelines
- Identifies and coordinates referrals and other community resources
- Implements system of care that closely monitors high risk patients to prevent / intervene early during acute exacerbations
- Ensures therapies are arranged as directed by the practitioner and provides appropriate follow-up and monitoring as needed
- Ensures medication reconciliation is completed and documented for all assigned patients according to Population Health guidelines
- Performs patient follow-up calls for issues, feedback and continued follow-up needs, per care management protocol and recommended timelines
- Assists with data collection and closing of care gaps and quality metrics as assigned and assists the healthcare team in meeting all of the quality metrics
- Facilitates problem-solving with the patient/family to mobilize patient resources
- Evaluates and refines the initial assessments and goal achievements in collaboration with the healthcare team
- Advocates for patient/family in assisting the health care team in understanding patient’s rights
- Works cohesively with the healthcare team in discharge planning to link patients with the most appropriate resources
- Identifies opportunities for process improvement in all aspects of patient care
- Attends meetings and participates on committees as requested
- Reviews current literature and attends training sessions and seminars to keep informed of new developments in the field
- Performs other related duties and responsibilities as directed
- Understands and models UHG’s mission and culture standards during all workplace interactions
- Participates and collaborates with other members of the Population Health Team and during Pop Health initiatives, to better care and meet the needs of our AHN patients
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.
- Active, unrestricted RN license in Ohio
- 2+ years of experience in a hospital, acute care or direct care setting
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
- Certified Case Manager (CCM)
- Experience or exposure to discharge planning
- Experience in utilization review, concurrent review or risk management
- Experience in a telephonic role
- Case management experience
- Managed care background
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.