Care Transitions Nurse Navigator

Optum; San Bernardino (CA); Remote; USD 48,000 - 87,000; Full time

Benefits offered by this job

Benefits package

401(k) contribution

Incentive & recognition programs

Job summary

Optum Home & Community Care Transitions, part of Optum and UnitedHealth Group, blends care coordination and technology to support seniors transitioning from hospital to home. This full-time, remote role engages patients and families, conducts SNF assessments, and collaborates with care teams to ensure CMS guidelines are followed.

The position requires an active clinical license and 5+ years of clinical experience, with eligibility for on-site facility needs within 30 miles of the home location.

Qualifications

• Active, unrestricted clinical license in the state of hire (RN, PT, OT, or SLP).
• 5+ years of clinical experience.
• Driver's license and reliable transportation.
• Reside within or near the county listed on the job description.

Responsibilities

• Engage with patients, families, or caregivers weekly and as needed, coordinating along discharge goals.
• Collaborate with care teams and participate in interdisciplinary meetings.
• Review target outcomes and discharge plans with providers and families.
• Perform SNF assessments using CMS criteria upon admission and during stays.
• Assess ongoing appropriateness for SNF per CMS criteria.
• Complete SNF continued stay reviews and update authorizations timely.
• Review referral requests for utilization management as instructed by licensed physicians.
• Cross-train and cover multiple contracts/clients to support coverage needs.
• Manage assigned caseload efficiently with good time management.
• Enter timely and accurate documentation into Coordinate.
• Adhere to policies and protect PHI in compliance with HIPAA and regulations.
• Stay current on CMS guidelines and regulations relevant to care transitions.
• Attend Care Transitions meetings as required.
• Maintain a positive attitude and supportive work environment.
• Perform other duties as required.

Skills

Active unrestricted license

Clinical experience

Driver's license & transportation

Strong communication

Microsoft Office

Education

Licensed clinician (RN/PT/OT/SLP)

Tools

Microsoft Office

Job description

Optum Home & Community Care Transitions, part of Optum and UnitedHealth Group, blends care coordination and technology to support seniors transitioning from hospital to home. This full-time, remote role engages patients and families, conducts SNF assessments, and collaborates with care teams to ensure CMS guidelines are followed.

The position requires an active clinical license and 5+ years of clinical experience, with eligibility for on-site facility needs within 30 miles of the home location.