Optum
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Patient Care Manager, RN
role at
Optum
Explore opportunities with Mederi Caretenders, a part of LHC Group, a leading post‑acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.
Primary Responsibilities
Receives referrals and ensures appropriate clinician and/or therapist(s) assignments for timely patient evaluation by signing off after authorization and plotting start of care (SOC) visits
Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals
Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance to physician orders
Oversees and assures development, implementation, and updates to the individualized patient plan of care, as appropriate
Manages and documents phone calls from physicians, clinicians, patients, referral sources, and communicates patient updates/new orders to clinicians
Uses coordination notes to document, as needed and appropriate
Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians with recommendations, as appropriate
Coordinates all aspects of care with all disciplines, physicians, durable medical equipment providers, caregivers/family members, transferring facilities, and any other applicable healthcare providers
Follows‑up on lab and other clinical diagnostic test, physician contact, and significant changes in the patient condition to ensure adequate physician notification, follow‑up, and needed plan of care modifications and communicates such to clinicians
Schedules, prepares for, facilitates, and documents case conference/SOC reports and facilitates effective exchange of information across disciplines especially with adverse findings, changes in patient condition, daily and urgent updates, as necessary
Assists clinicians in coordinating the transfer and discharge of patients from agency services as indicated by the physician
Receives report from field clinicians prior to scheduled days off on patient status and ongoing needs
Processes new orders and updates the visit frequency, as appropriate, when the on‑call RN takes supplemental verbal orders which alter frequency going forward
Writes and processes orders when taking verbal orders directly from the physician and communicates such to field clinicians
Assures payer change documentation is completed properly and timely, as required
Reviews clinician visit notes weekly to ensure timely, complete, appropriate, and accurate submission of all documentation by field staff
Takes necessary action to correct adverse findings and communicates trending to clinical director
Reviews, evaluates, and supervises service delivery to ensure appropriateness of care and utilization of services, equipment, and supplies through activities such as random patient visits, medical record reviews and case conferences
Enters infections and incidents/occurrences into the online Risk Management Incident Reporting System, as specified by policy
Assists in the orientation of new agency personnel
Provides direction and leadership to clinical team members in collaboration with the clinical director
Provides direct patient care, as necessary, in accordance to scope of practice and physician orders
Participates in QAPI program
Assures compliance with and ensures timely follow up on daily clinical and coding edits
Directs clinicians in utilizing best practice interventions when finalizing Plan of Care for all patients
Participates in on‑call rotation
Follows‑up with On‑Call events daily
Receives report from weekend and after‑hours clinicians admitting new patients
Completes LHC required learning courses, additional assignments per Executive Director request, as well as any state specific required training per state regulation/practice act requirements
Directs team in adherence to and participates in the Episode Management process
All other duties as assigned
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
Current RN licensure in state of practice
Current CPR certification
Current Driver's License, vehicle insurance, and access to a dependable vehicle or public transportation
State Specific Requirement
RN licensure must have no restrictions: FL
Compensation and Benefits Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. The salary for this role will range from $72,800 to $130,000 annually based on full‑time employment. 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. We comply with all minimum wage laws as applicable.
EEO Statement 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.
Drug‑Free Workplace UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.
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Patient Care Manager, RN
role at
Optum
Explore opportunities with Mederi Caretenders, a part of LHC Group, a leading post‑acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.
Primary Responsibilities
Receives referrals and ensures appropriate clinician and/or therapist(s) assignments for timely patient evaluation by signing off after authorization and plotting start of care (SOC) visits
Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals
Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance to physician orders
Oversees and assures development, implementation, and updates to the individualized patient plan of care, as appropriate
Manages and documents phone calls from physicians, clinicians, patients, referral sources, and communicates patient updates/new orders to clinicians
Uses coordination notes to document, as needed and appropriate
Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians with recommendations, as appropriate
Coordinates all aspects of care with all disciplines, physicians, durable medical equipment providers, caregivers/family members, transferring facilities, and any other applicable healthcare providers
Follows‑up on lab and other clinical diagnostic test, physician contact, and significant changes in the patient condition to ensure adequate physician notification, follow‑up, and needed plan of care modifications and communicates such to clinicians
Schedules, prepares for, facilitates, and documents case conference/SOC reports and facilitates effective exchange of information across disciplines especially with adverse findings, changes in patient condition, daily and urgent updates, as necessary
Assists clinicians in coordinating the transfer and discharge of patients from agency services as indicated by the physician
Receives report from field clinicians prior to scheduled days off on patient status and ongoing needs
Processes new orders and updates the visit frequency, as appropriate, when the on‑call RN takes supplemental verbal orders which alter frequency going forward
Writes and processes orders when taking verbal orders directly from the physician and communicates such to field clinicians
Assures payer change documentation is completed properly and timely, as required
Reviews clinician visit notes weekly to ensure timely, complete, appropriate, and accurate submission of all documentation by field staff
Takes necessary action to correct adverse findings and communicates trending to clinical director
Reviews, evaluates, and supervises service delivery to ensure appropriateness of care and utilization of services, equipment, and supplies through activities such as random patient visits, medical record reviews and case conferences
Enters infections and incidents/occurrences into the online Risk Management Incident Reporting System, as specified by policy
Assists in the orientation of new agency personnel
Provides direction and leadership to clinical team members in collaboration with the clinical director
Provides direct patient care, as necessary, in accordance to scope of practice and physician orders
Participates in QAPI program
Assures compliance with and ensures timely follow up on daily clinical and coding edits
Directs clinicians in utilizing best practice interventions when finalizing Plan of Care for all patients
Participates in on‑call rotation
Follows‑up with On‑Call events daily
Receives report from weekend and after‑hours clinicians admitting new patients
Completes LHC required learning courses, additional assignments per Executive Director request, as well as any state specific required training per state regulation/practice act requirements
Directs team in adherence to and participates in the Episode Management process
All other duties as assigned
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
Current RN licensure in state of practice
Current CPR certification
Current Driver's License, vehicle insurance, and access to a dependable vehicle or public transportation
State Specific Requirement
RN licensure must have no restrictions: FL
Compensation and Benefits Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. The salary for this role will range from $72,800 to $130,000 annually based on full‑time employment. 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. We comply with all minimum wage laws as applicable.
EEO Statement 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.
Drug‑Free Workplace UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.
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