4 days old

Telephonic Supervisor Inpatient Case Manager - RN - Irvine, CA - 900029

Irvine, CA 92606
  • Job Code
    900029

AtMonarch HealthCare, an OptumCare Company, you will perform within an innovative culture focusing on transformational change in the health care system. You will leverage your skills across a diverse and multi - faceted business. Your contributions will have an impact greater than you have ever imagined! Join us and help people live healthier lives while doingyour life's best work.(sm)

Supervises the Inpatient Clinical Services nurses in the Inpatient Clinical Services Department.Responsible for assisting the Manager of Inpatient Clinical Services with the daily operational activities, direction, coordination, and evaluation of these employees.Administer supervisory responsibilities in accordance with organizational and departmental policies/procedures, and applicable laws.Responsibilities include participating in the interviewing, hiring, and training of employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and problem resolution.


*Allowing 100% remote capacity through the COVD-19 pandemic. This position is leading a team of Nurses remotely. The regional office is located in Irvine, CA.

Primary Responsibilities:

  • Provides daily supervision of assigned staff, which may include RN, LVN and clerical personnel.
  • Expert knowledge of the job duties/functions of the Hospital Case Managers.
  • Expert knowledge of industry accepted criteria (e.g. Milliman, Interqual), CMS and Health Plan guidelines and appropriate application.
  • Assist with coordination of rates, providers, and other issues for complex cases needing out-of-network care.
  • Monitor and evaluate employee productivity and performance.Adjust workflow and responsibilities according to business and operational needs.
  • Oversee to day-to-day operations of the Hospital(i.e. ability to cover for illness, vacation, etc.).Actively provides on-site or telephonic review if coverage is required.
  • Assist with the completion of performance appraisals for Hospital Case Manager.
  • Actively participates in the ongoing development of the Inpatient Clinical Services department, i.e. policies and procedures, special projects, staff meetings and other departmental meetings/committees promoting Monarch HealthCare's core ideals and values.
  • Provides orientation and ongoing training for new employees as needed.
  • Performs on-call duties as scheduled on a rotating basis.
  • Efficiently navigates and utilizes computer data entry programs including but, not limited to: Microsoft Office (Outlook, Word, and Excel), Right Fax, Adobe Reader for fax attachment process and acts as a resource to staff.
  • Regular and consistent attendance.

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 and unrestricted California RN
  • 2+years of clinical experience in anacute inpatient clinical experience
  • 1+ years of Case Management experience
  • You will be asked to perform this role in an office setting or other company location.
  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.
Preferred Qualifications:
  • Bachelor's degree (BA) from four year college or university
  • Experience working with Millimanor InterQual
  • Certified Case Manager (CCM)

What's the first thing that happens when one of the most successful physician groups in Orange County comes together with a global leader in health care? Opportunity. With Monarch HealthCare joining OptumCare and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. With a vibrant network of hospitals and urgent care centers, we're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting opportunity to doyour life's best work.(sm)

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.

Job Keywords: RN, Supervisor, UM, utilization management, case manager, inpatient, hospital, acute, Milliman, Interqual, CMS, Irvine, Santa Ana, Anaheim, CA


Categories

Posted: 2021-04-05 Expires: 2021-05-05

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Telephonic Supervisor Inpatient Case Manager - RN - Irvine, CA - 900029

UnitedHealth Group
Irvine, CA 92606

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