RN Care Manager
Company: DaVita Medical Group
Posted on: November 10, 2019
Full-time opportunity for an RN Care Manager in our Care Management
DepartmentOverview of Position: Responsible for coordinating care
for patients attributed to DaVita Medical Group.? Collaborative
care with patients, their providers, and various community
resources to ensure assessment of medical conditions are completed
then coordinate a plan of care with patient driven goals to meet
individual healthcare needs.? Promotes quality of care and cost
effective outcomes.? Serves as a resource for patients, teammates
and providers. ?Ensures compliance to contractual and service
standards as identified by relevant health insurance plans and
DaVita Medical Group.? This is performed under the direct
supervision of the Medical Director, Care Management.Essential
- Provides case management coordination to ensure that patients
receive the appropriate level of care based on medical needs.?
- Develops alternate plans and assist patients and Providers to
navigate the healthcare system optimizing benefits.? Refer services
to networked Providers when possible.
- Uses professional judgment and departmental guidelines to refer
cases to physician advisors.
- Ensures compliance with HIPAA and other applicable company
policies and procedures as well as regulatory requirements.
- Identify and address opportunities for quality improvement in
all aspects of serving our customers.? Assist in planning and
implementation of systems changes and procedures to achieve overall
- Maintain effective communication with management regarding
development within areas of assigned responsibilities and performs
special projects as required.
- Performs other duties as assigned.Education:Required-
Associates Degree in NursingPreferred- Bachelor?s degree or higher
in healthcare related fieldExperience:Required- Three (3) years of
previous job related experience in a healthcare
environment.Preferred- Two (2) years? experience providing case
management and/or utilization review functions within health plan
or integrated system.Required licensure: Required- Valid NM RN
License or valid multi-state compact licensePreferred- Utilization
Review or Case Management Certificate.Knowledge, Skills,
Abilities:PC proficient; ability to communicate and interact
professionally with co-workers, management patients, and
Providers;? ability to counsel and/or consult; working knowledge of
HMO?s, PPO?s, Medicare, Medicaid, and insurance plans; knowledge of
CPT4/ICD 9 & 10/HCPCS codes.What's the first thing that happens
when one of the leading independent medical groups in the country
comes together with a global leader in health care? Opportunity.
With DaVita Medical Group, HealthCare Partners, The Everett Clinic,
Northwest Physicians Network, MountainView Medical Group and Magan
Medical Clinic joining OptumCare and the UnitedHealth Group family
of companies, people like you will find increasing levels of
challenge, impact and professional success. We're changing health
care for the better by improving access to affordable, high quality
care, and working together to improve the patient experience. That
takes passion, commitment, intense focus and the ability to
contribute effectively in a highly collaborative team environment.
Are you with us? Learn more about this exciting opportunity to do
your life's best work.(SM)Careers with OptumCare. Here's the idea.
We built an entire organization around one giant objective; make
the health system work better for everyone. So when it comes to how
we use the world's large accumulation of health - related
information, or guide health and lifestyle choices or manage
pharmacy benefits for millions, our first goal is to leap beyond
the status quo and uncover new ways to serve. OptumCare, part of
the UnitedHealth Group family of businesses, brings together some
of the greatest minds and most advanced ideas on where health care
has to go in order to reach its fullest potential. For you, that
means working on high performance teams against sophisticated
challenges that matter. Here you?ll find incredible ideas in one
incredible company and a singular opportunity to do your life's
best work.(SM)Diversity creates a healthier atmosphere: OptumCare
and its affiliated medical practices are 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 and its affiliated
medical practices is a drug-free workplace. Candidates are required
to pass a drug test before beginning employment.
Keywords: DaVita Medical Group, Albuquerque , RN Care Manager, Executive , Albuquerque, New Mexico
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