Description

Opportunities with ProHealth Physicians, part of the Optum family of businesses. When you work at ProHealth Physicians, your contributions directly sustain the health and well-being of our community. Discover high levels of teamwork, robust medical resources and a deep commitment to exceptional care and service. Join a leading community-based medical group and discover the meaning behind Caring. Connecting. Growing together.

Are you ready to make a positive impact in health care? If so, you're the missing piece in our care team. As part of the Optum and UnitedHealth Group family, ProHealth Physicians offers new opportunities for growth. Here, you'll experience:

• Exceptional teamwork
• Robust medical resources
• Passionate professionals with a focus on patient-centered care

Position Details:

• Location: Hybrid position, based out of Farmington CT
• Department: Case Management
• Schedule: Full time, 40 hours/weekly. Monday through Friday, hours 8:00AM - 4:30PM

Our Case Managers (CM) are RNs who are responsible for the coordination of care for high-risk patients (chronic/complex conditions) in the community setting to help keep them out of the hospital while remaining in a safe home environment with quality of life. The CM acts as a longitudinal advocate who links the patient and care givers with the network of care team members to help them gain knowledge of their disease process and to identify community resources for continued growth toward the maximum level of independence.

Primary Responsibilities:

• Stratifies and /or validates patient level of risk and manages patients across the continuum of care inclusive of care coordination, case management and complex case management
• Collaborates effectively with physicians, patients/caregivers and families to formulate a patient centric plan of care that meets the medical, psychosocial and financial goals of the patient inclusive of both short- and long-term goals
• Develops and continuously updates patient centric care plan inclusive of problem, goal, barrier and intervention, enters timely and accurate data into designated care management applications as needed to communicate patient needs
• Explores care options to reduce cost, decrease length of stay, curtail re-admission and influence quality outcomes
• Works collaboratively with the Utilization Management/Case Management RNs at the Health Plans, and other Care Team members to facilitate smooth care transitions as well as continuous case management activities
• Consults with Medical Directors and/or other appropriate programs/resources to overcome barriers to meeting goals and objectives and presents cases to appropriate resources to obtain multidisciplinary view in order to achieve optimal outcomes
• Maintain a comprehensive working knowledge of community resources, payer requirements and network services for target population to maximize benefit to patient overall well-being
• Attends and participates in interdisciplinary team meetings as directed
• Other duties as assigned

ProHealth Physicians is Connecticut's leading community-based medical group. Formed in 1997, we have primary care offices in every county. Our 300+ doctors and advance practice clinicians care for children and adults of all ages. We also have in-house imaging and clinical lab services. Traditional medicine treats people when they're sick. Instead, we focus on preventing diseases. Our goal is to give our patients - and their communities - the tools they need to be and stay well. This is how we help people live healthier lives. Together, we're making health care work better for everyone.

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 program for professional nursing education
• Current, unrestricted RN License in the State of Connecticut
• 1+ year(s) of Nurse Case Management experience (hospital, health insurance, care management organization, provider group setting)
• Experience with Electronic Health Records
• Reliable transportation

Preferred Qualifications:

• Bachelor of Science in Nursing
• Certified Case Manager (CCM)
• 3+ years of Nurse Case Management experience
• Experience with Epic

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. 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. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

OptumCare 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.

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