Medical Behavioral Integration - MBI - Nurse Care Manager
Company: Optum
Location: Ogden
Posted on: April 24, 2024
Job Description:
$5,000 Sign-on Bonus for External Candidates
For those who want to invent the future of health care, here's your
opportunity. We're going beyond basic care to health programs
integrated across the entire continuum of care. Join us to start
Caring. Connecting. Growing together.
The Medical Behavioral Integration Nurse is a specialized component
of the Optum Care Management Team. This position integrates a
collaborative process which plans, implements, coordinates,
monitors and evaluates options and services to meet the member's
medical and behavioral health needs, using education,
communication, and all available resources to promote quality,
cost-effective outcomes.
Primary Responsibilities:
- Screens and identifies members with high-risk, long term
chronic conditions who will benefit from care management services.
Monitors utilization as needed. Referrals for cases may originate
from various sources
- Performs member evaluations and onsite visits as needed in
multiple settings, including but not limited to: telephonic,
member's homes, PCP/Specialists clinic, hospital, and skilled
nursing facilities and provides feedback on planned interventions
and outcomes of the plan of care
- Performs comprehensive assessments, identifies, and assists
members with high-risk symptoms/diagnoses and/or members with
multiple co-morbidities who will benefit from intervention and
engaging in care management services, information is collected from
the patient, caregiver(s), health care providers and other relevant
parties as needed
- Documents findings and develops individualized care plans in a
concise/comprehensive manner compliant with documentation
requirements and Center for Medicare and Medicaid Services (CMS)
regulations
- Utilizes advanced clinical skills to make effective decisions
to meet the member's health, behavioral health and psychosocial
needs, providing coaching, patient education, communication, and
all available resources to promote quality and cost-effective
outcomes
- Documents patient/family status, diagnosis, medications,
treatment plan, goals, interventions, evaluation results,
observations and progress in electronic medical record/proprietary
database in a timely and accurate manner
- Advocates for members and families as needed to ensure the
patient's needs and choices are fully represented and supported by
the health care team
- Integrates a collaborative approach by attending
interdisciplinary team meetings with nurses, physicians and patient
care coordinators regarding patient care as needed; Collaborates
with providers to determine acuity of behavioral health concerns
and refer members to appropriate community resources
- Utilizes professional knowledge and critical thinking skills to
facilitate MD consultation on complex and/or complicated cases
- Applies Nursing/Counseling/Social Work theory, knowledge,
professional ethics, methods, and interventions to improve member
health and psychosocial functioning within the scope of licensure
and job function
- Manages assigned case load in an efficient and effective manner
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:
- Licenses must be active and unrestricted
- 3+ years of RN experience in a hospital setting, acute care,
direct care, or as a telephonic Case Manager for an insurance
company
- Proficient computer skills and good working knowledge of
Microsoft Word
- Proven ability to function independently and responsibly with
minimal supervision
- Proven ability to maintain direct and open communication with
all levels of the organization
- Proven ability to handle sensitive issues with members and
providers in a confidential manner according to HIPAA
guidelines
- Proven ability and flexibility to assume responsibilities and
tasks in a constantly changing work environment
- Proven excellent customer service skills
- Proven excellent interpersonal and problem-solving skills
- Proven solid team player and team building skills
- Proven demonstrates initiative in achieving individual, team,
and organizational goals and objectives
- Proven solid oral and written communication skills -
specifically telephone skills
- Willing or ability to travel locally up to 75% of the time
Preferred Qualifications:
- BSN
- Licensed RN with 3+ years of experience
- Certified Case Manager (CCM)
- 3+ years of experience in a related mental health
environment
- Dual diagnosis experience with mental health and substance
abuse
- Experience working in an environment that required coordination
of benefits and utilization of multiple groups and resources for
patients
- Experience working with low-income populations
- Experience working with the aged, blind or disabled
- Clinical training experience
- Managed Care experience
- Case Management experience
- Experience or exposure to discharge planning
- Experience in utilization review, concurrent review or risk
management 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: OptumCare is an 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 is a drug-free workplace. Candidates are required to pass
a drug test before beginning employment
Keywords: Optum, Ogden , Medical Behavioral Integration - MBI - Nurse Care Manager, Executive , Ogden, Utah
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