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    Registered Nurse - Indianapolis, United States - Professional Management Enterprises

    Professional Management Enterprises
    Professional Management Enterprises Indianapolis, United States

    5 days ago

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    Description

    Job Description

    Job Description

    Primary Responsibilities:

    • Selects, manages, develops, mentors and supports staff in designated department or region
    • Develops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for results
    • In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements
    • Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements
    • Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence
    • Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care
    • Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services
    • Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
    • Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team
    • Participates in training and coaching of direct reports as needed
    • Conducts bi-annual field visits with direct reports to observe, provide areas of teaching, address issues and concerns and foster a good working relationship
    • Collaborates across Optum and UHG and interacted with Medical Directors, Site Directors, Senior Leaders, Network, Marketing, Account Management, Quality, Product, and other stakeholders

    Required Qualifications:

    • Resident of Indiana

    • BSN or BSW with equivalent experience

    • Registered Nurse with an unrestricted License in Indiana

    • Experience working within the community health setting in a health care role

    • Experience or knowledge of Indiana Medicaid, Medicare, Long term care

    • Experience coaching or mentoring staff

    • Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment


    Preferred Qualifications:

    • 3+ year of case management leadership experience within a healthcare industry

    • Background in managed care

    • Case Management experience

    • Certified Case Manager (CCM)

    • Experience / exposure with members receiving long term social supports

    • Experience in utilization review, concurrent review and/or risk management

    Company DescriptionProfessional Management Enterprises is a minority and veteran owned business that partners with major healthcare providers to find quality employees and thrives on helping people find positions that exceeds their expectations.

    Company Description

    Professional Management Enterprises is a minority and veteran owned business that partners with major healthcare providers to find quality employees and thrives on helping people find positions that exceeds their expectations.
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