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.
The Care Manager RN - Per Diem 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.
Schedule: Flexible Schedule - Required to work 1 Saturday Quarterly
Location: 175 Foreriver Parkway, Portland, ME
Primary Responsibilities: Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an educational resource to all Health System staff regarding utilization review
Assumes roles in assessment physical, psychosocial, & economic needs for transition of care planning to a variety of levels of care, delegates to others as appropriate
Documents, verifies, and validates specific data required to monitor and evaluate interventions and outcomes
Interviews and collects patient specified data and chart review related to readmission and appropriately notifies care team
Communicates telephonically and electronically with outpatient providers in an effort to enhance the continuum of care
Integrates performance improvement principles and customer service excellence principles into all aspects of job responsibilities, practice and governmental commercial payer guidelines
Adheres to the policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodies
Assumes responsibility for Health System required continued education and owns professional growth
Performs tasks of a clinical nature within scope of assigned duties and clinical expertise
Communicate effectively in both oral and written form, as appropriate for the needs of the audience
Performs other duties as assigned or required
Benefits: 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.)
Required Qualifications: Associate's degree (or higher) in Nursing
Current, unrestricted RN license in the state of employment
1+ years of experience in a hospital, acute care, or direct care setting
Intermediate level of ability to type, and navigate a Windows based environment
Ability to work one Saturday, quarterly
Preferred Qualifications: Bachelor's degree in Nursing (BSN)
Certified Case Manager (CCM)
1+ years of Case management experience
Experience or exposure to discharge planning
Previous background in managed care
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). The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment.
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.