Talent.com
Case Manager RN
Case Manager RNOptum • Bangor, ME, United States
No longer accepting applications
Case Manager RN

Case Manager RN

Optum • Bangor, ME, United States
30+ days ago
Job type
  • Full-time
Job description

Opportunities at Northern Light Health , in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind : Caring. Connecting. Growing together.

The Care Manager, RN provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients / caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Facilitates appropriate LOS, patient experience, and reimbursement for all patients. Develops and maintains collaborative relationships with all members of the healthcare team. Through clinical care coordination drives efficient utilization of resources to reduce length of stay, improve patient flow and throughput, limits variation by applying innovative and evidence-based practice, and to reduce the risk of readmission.

Location : Eastern Maine Medical Center - 489 State St, Bangor, ME

Primary Responsibilities :

  • Effectively problem-solves and actively pursues resolution
  • Directly communicates with staff, physicians, patients, and families
  • Role models leadership behavior through courtesy, respect, and efficiency
  • Coordinates patient care processes to achieve desired quality outcomes and identifies / controls inappropriate resource utilization
  • Facilitates patient and family education and promotes continuity of care to achieve optimal patient outcomes. Assures patient rights by offering a choice when appropriate
  • Reviews the patient plan of care with the multi-disciplinary team. Facilitates and participates in multi-disciplinary team care conferences for patients with complex problems. Communicates in the medical record and verbally with the team to coordinate interventions and facilitate continuity of care
  • Daily communication and collaboration with the patient care staff to provide continuous assessment, evaluation, and continuum planning to assure the patient receives the appropriate level of care at the appropriate time. Facilitates the implementation of nursing interventions as indicated by the multi-disciplinary team plan of care that enhances and compliments the skill level of the nursing staff
  • Functions without direct supervision, utilizing time constructively and organizing assignments for maximum productivity. Arrange schedule to facilitate meetings with physicians for patient care rounds, team meetings and other opportunities to improve communication
  • Adheres to name badge / dress code compliance

Utilization Management :

  • Knowledge of all applicable federal and state regulations. Demonstrates a working knowledge of managed care and Medicare health plans as well as reimbursement related to post-acute services within the continuum of care
  • Consults with physician section leaders for support in cases that continued stay is not appropriate, and case manager is unable to come to resolution by working with assigned physician
  • Responsible for communicating with the department director LOS and financial information, as well as issues that may affect the continuum of care process
  • Continuum of Care Planning :

  • The CM will be responsible for integrating the assessment of the need for post-hospital services and determination of an appropriate discharge plan for complex cases
  • Educates patient / family as to options / choices within the level of care determined to be appropriate. Initiates and ensures completion of all necessary paperwork
  • Facilitates completion of orders as required prior to transfer of patient to the next level of care in a timely manner so discharge is not delayed
  • Continuum of Care planning will emphasize education and collaboration with physicians, family members, clinical social workers, nursing staff, therapists, and case managers from contracted payors when appropriate to determine discharge plan that will be of maximum benefit to the patient. Involve staff from next level of care in the treatment plan as early as possible to promote continuity and collaboration
  • Reports on all relevant information to the staff assuming responsibility in the next level of care
  • Employees are expected to comply with all regulatory requirements, including CMS and Joint Commission Standards
  • Risk Management :

  • Interface with department directors, Risk Management, and patient representatives to identify potential QA or risk issues. Perform any necessary investigation, documentation and follow-up as required
  • Participates in departmental SQI projects
  • Must be able to functionally coordinate and discharge plan for all age groups, including but not limited to the unborn child through geriatric age groups
  • OTHER DUTIES / RESPONSIBILITIES

  • Ability to effectively read, write, and speak, cognitively process and emotionally support performing other duties as assigned
  • All employees are expected to remain flexible to meet the needs of the hospital, which may include floating to other departments to assist as the patient's needs fluctuate
  • What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include :

  • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
  • Medical Plan options along with participation in a Health Spending Account or a Health Saving account
  • Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
  • 401(k) Savings Plan, Employee Stock Purchase Plan
  • Education Reimbursement
  • Employee Discounts
  • Employee Assistance Program
  • Employee Referral Bonus Program
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
  • More information can be downloaded at : uhgbenefits (uhgbenefits)
  • You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

    Required Qualifications :

  • Associate's Degree (or higher) in Nursing
  • Current, unrestricted RN license in the state of Maine
  • 3+ years of experience in a hospital, acute care, or direct care setting
  • Intermediate level of proficiency to type and navigate a Windows based environment
  • Preferred Qualifications :

  • Bachelor's Degree (or higher) in Nursing (BSN)
  • Background in managed care
  • Case management experience
  • Certified Case Manager (CCM) and / or American Case Management Certification (ACM)
  • Experience or exposure to discharge planning
  • Experience in utilization review and concurrent review
  • Knowledge / understanding of community resources, policies, and procedures
  • Knowledge of Utilization Review, Medicare Requirements processes as well as State and Federal regulations pertaining to Utilization Review and Discharge Planning
  • Soft Skills :

  • Strong analytical, critical thinking and organizational skills
  • 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 salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

    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.

    UnitedHealth Group 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.

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

    #RPO #RED

    Create a job alert for this search

    Rn Case Manager • Bangor, ME, United States

    Related jobs
    Case Manager (Coordinator)-Treatment Foster Care

    Case Manager (Coordinator)-Treatment Foster Care

    Community Care ME • Bangor, ME, USA
    Full-time
    Quick Apply
    The Case Coordinator (CC) works collaboratively with other providers to coordinate services and facilitates the team process to ensure comprehensive, non-duplicative services to the client / family.C...Show more
    Last updated: 30+ days ago
    Travel Nurse RN - Psychiatric - $2,556 per week

    Travel Nurse RN - Psychiatric - $2,556 per week

    Genie Healthcare • Bangor, ME, United States
    Full-time
    Genie Healthcare is seeking a travel nurse RN Psychiatric for a travel nursing job in Bangor, Maine.Job Description & Requirements. Genie Healthcare is looking for a RN to work in Psychiatric for a ...Show more
    Last updated: 1 day ago • Promoted
    RN - ICU

    RN - ICU

    Northern Light Eastern Maine Medical Center • Bangor, ME, United States
    Full-time
    Northern Light Eastern Maine Medical Center.Required Certifications for Submittal.The Intensive Care / Coronary Care Registered Nurse is a professional nurse who coordinates the delivery of nursing...Show more
    Last updated: 30+ days ago • Promoted
    Travel RN - Telemetry - Bangor, Maine - $2608 / week

    Travel RN - Telemetry - Bangor, Maine - $2608 / week

    Vetted Health • Bangor, ME, United States
    Temporary
    Job Opportunity : RN - Telemetry.Coordinates total nursing care for patients.Participates in patient and family teaching. Provides leadership by working cooperatively with ancillary nursing and other...Show more
    Last updated: 2 days ago • Promoted
    Travel Nurse RN - OR - Operating Room - $2,332 per week

    Travel Nurse RN - OR - Operating Room - $2,332 per week

    IDR Healthcare • Bangor, ME, USA
    Full-time
    IDR Healthcare is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Bangor, Maine.Job Description & Requirements. IDR Healthcare is an awarding winning staffing firm that bel...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Psychology - $2,870 per week

    Travel Nurse RN - Psychology - $2,870 per week

    TNAA TotalMed RN • Bangor, ME, United States
    Permanent
    TNAA TotalMed RN is seeking a travel nurse RN Psychology for a travel nursing job in Bangor, Maine.Job Description & Requirements. TotalMed is a Top Ten, travel nursing and healthcare staffing agenc...Show more
    Last updated: 9 days ago • Promoted
    Travel Nurse RN - Manager, Long Term Care - $2,348 per week

    Travel Nurse RN - Manager, Long Term Care - $2,348 per week

    Medical Solutions LTC • Orono, ME, US
    Full-time
    Medical Solutions LTC is seeking a travel nurse RN Manager, Long Term Care for a travel nursing job in Orono, Maine.Job Description & Requirements. We're seeking talented healthcare professional...Show more
    Last updated: 1 hour ago • Promoted • New!
    Travel Nurse RN - Intermediate Care

    Travel Nurse RN - Intermediate Care

    Magnet Medical • Bangor, ME, US
    Full-time
    Magnet Medical is seeking a travel nurse RN Intermediate Care for a travel nursing job in Bangor, Maine.Job Description & Requirements. Magnet Medical Job ID #34850668.Pay package is based on 12...Show more
    Last updated: 30+ days ago • Promoted
    Travel RN - Behavioral Health

    Travel RN - Behavioral Health

    Travel Nurse Across America • Bangor, ME, United States
    Full-time
    We're looking for Psychiatric Nurses for an immediate travel nurse opening in Bangor, ME.The right RN should have 1-2 years recent psychiatric nursing experience. Read below for more requirements.As...Show more
    Last updated: 3 days ago • Promoted
    CRNA (m / w / d)

    CRNA (m / w / d)

    IMN Anesthesia • Bangor, ME, United States
    Full-time
    LOCUM CRNA in Bangor, Maine •Job ID : 125411.Schedule / Coverage : Start in February 2026 + ongoing.In need of 8-hour and 10-hour shifts, but 12's are a possibility. Case Mix : A large variety of cases f...Show more
    Last updated: 3 days ago • Promoted
    Travel Nurse RN - Case Manager - $2,050 to $2,278 per week in York, ME

    Travel Nurse RN - Case Manager - $2,050 to $2,278 per week in York, ME

    TravelNurseSource • Bangor, Maine, US
    Full-time
    TravelNurseSource is working with Prime Time Healthcare to find a qualified Case Manager RN in York, Maine, 03909!.Now Hiring : RN Case Manager - York, ME. Contact us for Pay Information.Actual amoun...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Case Manager - $2,188 per week in York, ME

    Travel Nurse RN - Case Manager - $2,188 per week in York, ME

    TravelNurseSource • Bangor, Maine, US
    Full-time
    TravelNurseSource is working with Convergence Medical Staffing to find a qualified Case Manager RN in York, Maine, 03909!. Job Care Manager, City : York, State : Maine, Estimated Start , Shift : 5 x 8 ...Show more
    Last updated: 15 days ago • Promoted
    Travel Nurse RN - Manager, Long Term Care

    Travel Nurse RN - Manager, Long Term Care

    Medical Solutions LTC • Orono, ME, US
    Full-time
    Medical Solutions LTC is seeking a travel nurse RN Manager, Long Term Care for a travel nursing job in Orono, Maine.Job Description & Requirements. We’re seeking talented healthcare profes...Show more
    Last updated: 11 hours ago • Promoted • New!
    RN Case Manager, Home Health

    RN Case Manager, Home Health

    CenterWell Primary Care • Bangor, ME, United States
    Full-time
    Become a part of our caring community and help us put health first.Make a meaningful impact every day as a CenterWell Home Health nurse. You'll provide personalized, one-on-one care that helps patie...Show more
    Last updated: 3 days ago • Promoted
    RN - Med / Neuro Days - LOCALS ACCPETED

    RN - Med / Neuro Days - LOCALS ACCPETED

    InstantServe LLC • Bangor, ME, United States
    Full-time
    Per State Mandate All Healthcare Workers Must Be Fully Vaccinated from COVID-19Travelers Who Live within 50 miles of the facility will receive a lower local rate. JOB SUMMARYUnder the supervision of...Show more
    Last updated: 3 days ago • Promoted
    RN - IMC

    RN - IMC

    Northern Lights Eastern Maine Medical Center • Bangor, ME, United States
    Full-time
    Northern Lights Eastern Maine Medical Center.Magnet Medical is committed to providing accurate and transparent information regarding advertised pay for job positions. However, it's important to note...Show more
    Last updated: 3 days ago • Promoted
    RN - ICU Days

    RN - ICU Days

    Becker Health • Bangor, ME, United States
    Full-time
    Under the supervision of the Unit Director, the RN performs patient care functions as approved by the State of Maine Board of Nursing and St. Joseph Hospital policies and procedures.The Clinical Lea...Show more
    Last updated: 3 days ago • Promoted
    Adult Case Management

    Adult Case Management

    UCP of Maine • Bangor, Maine, United States
    Full-time
    Quick Apply
    UCP of Maine offers Adult Case Managers : .Clinical Supervision for those interested in pursuing their LSW A supportive team competitive pay and benefits package. Competitive earned time and three flo...Show more
    Last updated: 27 days ago