RN Case Manager, Cardiology - Las Vegas, NV

About the role

Optum NV is seeking a Case Manager RN - Cardiology to join our team in Las Vegas, NV. This position is responsible for the care management and coordination of high risk high need patients assigned to a specific site, including both in and out patient clinical care. The Complex RN Case Manager will work in the Cardiology department, assisting with the CHF clinic, remote telemonitoring of patients, and setting up other clinics/programs.

Responsibilities

• Apply case management standards of practice to focus on effective care of high risk high need patients at a specific site
• Serve as a patient advocate and resource and provide critical information and recommendations to the rest of the care team
• Participate in assessment activities to develop individualized plans of care in coordination with patient, family and providers
• Follow patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care delivery
• Maintain strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomes
• Work collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of care
• Aid clinicians in implementing best practices for chronic care and disease management
• Provide patient education on disease processes to help promote self-management and compliance
• Maintain an active caseload and provide interventions as needed within area of expertise and within their scope of practice
• Manage heart failure disease management (telephonic and/or in person), focusing on adherence to lifestyle changes, symptoms recognition by patients, developing individualized treatment plans with patients, and helping patients with the implementation of the treatment plan
• Ongoing monitoring of patients treatment plans, adherence, if goals are achieved and evaluation of care; assist in reducing readmission rates
• Exercise sound judgment (Critical Thinking Skills) in evaluating situations and making decisions; notify appropriate staff/providers in situations requiring assistance
• Make outbound telephone calls to patients to assess members' current health status
• Provide telephonic nursing support to patients/caregivers related to disease process, signs and symptoms to report, telemonitoring, individual treatment plans, medications and for any additional concerns
• Maintain monthly statistics generated from current patient case load and telephonic patient case load
• Communicate with customers in a manner that is clear, concise and understandable. Utilize appropriate phone etiquette and effective listening skills when interacting with customers/family
• Maintain relevant training and certifications related to management of procedures and protocols (e.g., LearnSource; CPR; ACLS)
• Function as a resource for other co-workers and new hires, assist to help answer questions and direct them to the needed resources
• Assist Supervisor and/or Manager with department related projects by completing tasks correctly and efficiently

Qualifications

• High School diploma or equivalent
• Registered Nurse with active unrestricted license in the State of Nevada
• Valid Nevada driver's license and personal auto insurance coverage
• BLS certification or obtain within 30 days of hire
• 3+ years of nursing experience with direct patient care in a Critical Care setting (Critical Care, general ICU, ER)
• Demonstrated ability to perform case management activities
• Strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and capacity for continued learning
• Excellent verbal and written communication skills including excellent phone etiquette and customer service skills
• Competent with MS Office, Excel and other practice management systems or ability to continue to learn new programs

Skills

• Knowledge of UM and plan benefit designs
• Ability to exercise sound judgment and critical thinking skills
• Ability to communicate effectively with patients, families, and providers
• Ability to use technology and software applications

Benefits

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).

Pay

The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Company Information

We are 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.

Equal Opportunity Employer

We are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.