 |
RN Case Manager - Eugene Oregon
Company: Optum
Location: Eugene, Oregon
Posted On: 05/09/2025
$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.
-
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
-
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: -
|
 |
RSS Job Feeds