Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

Positions in this function provide nursing telephonic assessment, individualized care, and care coordination for patients receiving telephonic services from the call center environment and according to Optum policies and procedures, scope of practice, and certification.

Primary Responsibilities: 

• Positively represent the Company to both internal and external customers; always maintain a professional and courteous manner
• Uphold the Optum core values in the conduct of work
• Adhere to Company privacy guidelines; ensure compliance with local, state, and federal regulations
• Assess patients prior to initiation of home care service for appropriateness of services prescribed
• Provide services according to Optum policy and the prescriber’s plan of treatment
• Individualize patient assessments based on care/services being provided and patient need
• Ensure interventions respect and encourage the patient’s ability to make choices
• Respect each patient’s rights and conduct business in an ethical manner
• Educate patients and families with a systematic approach, promoting patient understanding of treatment and services, health status, coping ability and patient/family involvement in the continuum of care or service
• Initiate the plan of treatment/care pathway based upon the analysis of information obtained and within scope of practice and certification
• Coordinate care with the patient services centers, pharmacists, dietitians, and other healthcare professionals to promote the continuum of care or service
• Accurately communicate (written/verbal) patient status information to prescribing physician and case manager in timely manner and provide necessary clinical information to Optum pharmacists and other healthcare professionals as applicable
• Provide care and services to assigned caseload in an efficient, organized manner. Maintain flexibility in assignments and scheduling
• Modify the plan of care, as appropriate, based on re-assessment, change in prescriber orders, the patient’s need for further care or services, and the achievement of identified goals within scope of practice and certification
• Complete clinical record documentation per Optum policy in a timely, complete, and accurate manner
• Provide service-related clinical support to key physicians/hospitals through personal contacts and in- services, as directed
• Participate in holiday and weekend duties as scheduled
• Ensure senior management decisions and directives are carried out
• Additional 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 unrestricted compact nursing license (RN) for state of residence
• Willingness to obtain license in selected state(s) as determined by the Organization
• Maintain competency on all Optum services provided according to Optum policy
• Participate in required continuing education, staff meetings, competency training, and assessments
• Maintain all other personnel requirements as outlined per Optum policy
• Exceptional communication skills (written and verbal)
• Possess skills to deal with patient/family conflict resolution and grievances
• Demonstrated ability to work with individuals with disabilities
• Maintain competency in the appropriate use of the computerized clinical systems
• Technology knowledge to include desktop/laptop computer proficiency; use of analytical software, Microsoft Office, Outlook (internet and email). Attend in-services on applicable technology enhancements
• Additional state required qualifications may apply

Preferred Qualifications: 

• BSN and CDE 
• 1+ years of obstetrical experience preferred, and diabetes nursing experience 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.    

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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. 

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

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