Transitional Care Nurse

About This Role

As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of health services by assessing and interpreting member needs and identifying solutions to help members live healthier lives. This role is ideal for those looking to make a significant impact in a collaborative healthcare environment.

Highlights

• Pay: $60,200 - $107,400/year
• Location: Kansas City, MO
• Brand/Division: Optum
• Schedule: Full Time, Day shift
• Residency: Must reside in MO

What You'll Do

• Perform initial and concurrent review of inpatient cases applying evidenced-based criteria (i.e. MCG/Interqual criteria)
• Discuss cases with facility healthcare professionals to obtain plans-of-care
• Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management
• Participate in discussions with the Clinical Services team to improve the progression of care to the most appropriate level
• Consult with the Medical Director, as needed, for complex cases and make appropriate referrals to downstream partners
• Apply clinical expertise when discussing cases with internal and external Case Managers and Physicians
• Identify delays in care or services and manage with MD
• Follow all Standard Operating Procedures in end-to-end management of cases
• Obtain clinical information to assess and expedite alternate levels of care
• Facilitate timely and appropriate care and effective discharge planning

Requirements

• Active, unrestricted RN license in state of MO

• 3+ years of clinical nursing experience in a hospital setting

• Active, unrestricted RN license in state of MO

About UnitedHealth Group

UnitedHealth Group is a leading healthcare provider committed to delivering exceptional patient care. They harness technology and innovation to make care simpler to navigate, more affordable, and more connected for the people they serve. The organization is dedicated to creating an inclusive workplace where everyone feels welcomed and valued.