Cardiology RN Case Manager SMA Las Vegas

Las Vegas, Nevada
May 17, 2022
May 21, 2022
Contract Type
Full Time
***$10,000 Sign On Bonus for External Candidates***

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)
Southwest Medical, part of OptumCare, is a multi-specialty group of physicians, Nurse Practitioners, and Physician Assistants consisting of over 300 providers, 21 medical health centers including six urgent care clinics, four convenient care centers, two lifestyle centers catering to older adults, an outpatient surgery center, home health, hospice and palliative care services, plus E-visits and online options via Now Clinic telemedicine technology. Southwest Medical offers patients compassion, innovation, and quality care throughout southern Nevada. Southwest Medical is headquartered in the greater Las Vegas, NV area.

As the Complex RN Case Manager you will be responsible for care management and coordination of care for high risk cardiac and congestive heart failure patients. You would be working in the Cardiology department. You will be working closely with the Cardiology Providers, assisting with the CHF clinic, assisting with remote telemonitoring of patients and assist management/providers to set up other clinics / programs that are of interest. The Complex RN Case Manager will have his/her own scheduled patients who come in for visits as well as those patients who will need to be reached telephonically. 
Primary Responsibilities:

  • Apply case management standards of practice to focus on effective care of high risk high need patients at a specific site
  • Serve as a patient advocate and resource and provide critical information and recommendations to the rest of the care team
  • Participates in assessment activities to develop individualized plans of care in coordination with patient, family and providers
  • Follows patient through various transitions of care to ensure that any gaps are identified and remedied and promote efficient health care delivery
  • Maintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomes
  • Works collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of care
  • Assist clinicians in implementing best practices for chronic care and disease management
  • Follow standard protocols, processes and policies to include but not limited to the following: Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designee
  • Making outbound calls to assess members' current health status
  • Identifying gaps or barriers in treatment plans
  • Providing patient education to assist with self-management
  • Interacting with Medical Directors on challenging cases
  • Coordinating care for members
  • Making referrals to outside sources
  • Coordinating services as needed (home health, DME, etc.)
  • Educating members on disease processes
  • Encouraging members to make healthy lifestyle changes
  • Documenting and tracking findings
  • Utilizing Milliman criteria guideline for patient care
  • Monitoring and evaluation of electronic data received in the Telemonitoring Software Application from remote biometric monitors located in the patient’s home
  • Demonstrated ability to perform case management activities
  • Demonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learning
  • Knowledge of UM and plan benefit designs
  • Ability to demonstrate knowledge of and apply those to the job function and responsibilities
  • Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action

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, unrestricted NV RN license or temporary NV RN license with the ability to obtain permanent NV RN license upon expiration of temporary NV RN license
  • 3+ years of clinical nursing experience with direct patient care in an acute care setting (preferably Critical Care, general ICU, ER) 
  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance
Preferred Qualifications:

  • Certification in Case Management and / or complex disease management
  • 1 + years of Case Management experience
  • Solid telemetry/EKG experience (able to read and interpret cardiac telemetry rhythms)
  • Medicaid, Medicare, Managed Care experience
  • Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
  • Experience in Home & Community based or Long Term Care services delivery
  • Computer / typing proficiency to enter / retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software application 
  • Bilingual skills

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Nevada Residents Only: The salary range for Nevada residents is $58,800 to $104,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 **PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis (“Internal Candidates”) are not eligible to receive a sign on bonus.

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 Case Manager, Cardiology, critical care, Las Vegas, NV, Nevada

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