RN Case Manager
Company: Optum
Location: Eugene
Posted on: May 8, 2025
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Job Description:
$7,500 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.
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Optum's Pacific West region is redefining health care with a focus
on health equity, affordability, quality, and convenience. From
California, to Oregon and Washington, we are focused on helping
more than 2.5 million patients live healthier lives and helping the
health system work better for everyone. At Optum Pacific West, we
care. We care for our team members, our patients, and our
communities. Join our culture of caring and make a positive and
lasting impact on health care for millions.
The Nurse Case Manager is responsible for performing case
management within the scope of licensure for patients with complex
and chronic care needs by assessing, developing, implementing,
coordinating, monitoring and evaluating care plans designed to
optimize health care across the care continuum and ensuring patient
access to services appropriate to their health needs. - -Basic
counseling skills and a positive, enthusiastic and helpful
personality are a must. Activities include coordination and
oversite of care plans and services of a defined patient population
program to promote effective utilization of services and quality
patient care.
Primary Responsibilities: -
Population Management
Analyzes data related to patient populations/conditions and
develops a plan of action. Monitors progress over time and
initiates changes as needed
Identifies patient populations requiring care management
support
Assesses patient populations to identify those resources or other
factors needed to achieve the desired outcome for health
maintenance or health improvement
Coordinates healthcare interventions for populations with
significant health conditions in which self-management efforts are
critical
Maintains appropriate patient educational materials for populations
of patients to meet the needs of patients and families in order to
assist with the facilitation of their participation in the plan of
care
Develops strategies to meet the preventive care and health
maintenance measures for populations of patients
Develops professional relationships with community resources that
are used by OMG to care for populations of patients. (e.g. Home
health, hospice)
Disease Management
Assists in the management of patients with chronic diseases
following established protocols and systems for disease management
in collaboration with providers
Assesses patient learning needs and has the ability to develop and
implement individualized educational or care plans. Reviews,
evaluates and revises the plan on an ongoing and timely basis. -
-Develops self-management goals and monitors the progress of the
goals
Communicates with a multidisciplinary team (physicians, nurses,
therapists, social workers, etc.) as needed to assist with disease
management
Has the ability to oversee and assist the patient with referral
navigation
Initiates disease-specific care conferencing as needed
Utilizes patient communication strategies, e.g. motivational
interviewing, to involve the patient in developing a plan of care,
goals or other specific measures pertinent to their health
condition
Assesses patient activation and readiness for change and uses these
to develop self-management goals
Documents all disease management encounters using standardized
processes
Utilization Management
Possesses analytical skills to assess various patient utilization
measures, such as ED, Urgent Care and Hospital Visits
Oversees ED, Urgent Care and Hospital admission utilization
rates
Collaborates with the Leadership team to develop a plan of action
to maintain acceptable utilization rates
Leadership
Works collaboratively with the MA, Community Health Worker or LPN
Clinic Coordinator, to promote activities that support the overall
goals of the organization related to caring for different
populations of patients
Engages the back office team and partners with leadership to
support the population, disease and utilization management process
goals and initiatives
Effectively communicates with staff members and providers. Can role
model excellent communication skills
Works collaboratively with the leadership team to ensure that the
staff comprehend and are compliant with the policies and procedures
that relate to population, disease and utilization management
Quality
Monitors monthly quality measures, looks for trends and makes plans
for improvements. - -Identifies problem areas for monitoring and
evaluation and is active in analyzing findings, changing practice
based on the findings. - -Works with the Quality Manager on process
and informs staff of trends and areas where improvement is
needed
Serves as an educational resource and provides consultation to
other staff on utilizing evidence-based criteria to maintain
quality measures
Participates, as a Clinic Team Member, in Quality Improvement
Projects and Initiatives
Perform other duties as assigned
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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: -
Graduate from an accredited school of nursing
Current Oregon Registered Nurse license
Current healthcare level BLS/CPR certification or the ability to
obtain within 30 days of employment
Current Oregon driver license in good standing and reliable &
insurance transportation
3+ years of experience as a licensed RN with recent clinical
experience or less RN experience with other/related healthcare
experience
Knowledge of community resources
Demonstrated knowledge and understanding of information
technology
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Preferred -Qualifications: -
Experience participating in a team-based model
Experience in motivational and health coaching with patients
The salary range for this role is $59,500 to $116,600 annually
based on full-time employment. Pay is based on several factors
including but not limited to local labor markets, education, work
experience, certifications, etc. UnitedHealth Group complies with
all minimum wage laws as applicable. In addition to your salary,
UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice
of benefits and incentives.
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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.
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Diversity creates a healthier atmosphere: OptumCare is an Equal
Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass
a drug test before beginning employment.
Keywords: Optum, Albany , RN Case Manager, Executive , Eugene, Oregon
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