Case Manager Registered Nurse - Per Diem Bangor, ME

Optum; Bangor (ME); On-site; USD 39,950 - 71,635; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

401(k) contribution

Job summary

Optum is seeking a Registered Nurse to coordinate patient care and facilitate discharge planning, ensuring quality outcomes at Eastern Maine Medical Center. Candidates must have a current RN license in Maine and at least 3 years of hospital experience.

The position offers hourly pay ranging from $29 to $52 based on experience, alongside a comprehensive benefits package.

Qualifications

• Current, unrestricted Registered Nurse license in Maine.
• 3+ years experience in a hospital or acute care setting.
• Intermediate level proficiency in Windows based environments.

Responsibilities

• Coordinates patient care processes to achieve quality outcomes.
• Facilitates patient and family education for optimal outcomes.
• Integrates assessment for discharge planning of complex cases.

Skills

Registered Nurse license

3+ years acute care experience

Analytical and critical thinking

Education

Bachelor's Degree in Nursing (BSN)

Tools

Cerner EMR

Job description

Location

Eastern Maine Medical Center - 489 State St, Bangor, ME

Must be available to work at least one weekend shift a month and one holiday a year.

Primary Responsibilities

• Effectively problem‑solves and actively pursues resolution
• Directly communicates with staff, physicians, patients, and families
• Role models leadership behavior through courtesy, respect, and efficiency
• Coordinates patient care processes to achieve desired quality outcomes and identifies/controls inappropriate resource utilization
• Facilitates patient and family education and promotes continuity of care to achieve optimal patient outcomes; assures patient rights by offering a choice when appropriate
• Reviews the patient plan of care with the multi‑disciplinary team; facilitates and participates in multi‑disciplinary team care conferences for patients with complex problems; communicates in the medical record and verbally with the team to coordinate interventions and facilitate continuity of care
• Daily communication and collaboration with the patient care staff to provide continuous assessment, evaluation, and continuum planning to assure the patient receives the appropriate level of care at the appropriate time; facilitates the implementation of nursing interventions as indicated by the multi‑disciplinary team plan of care that enhances and compliments the skill level of the nursing staff
• Functions without direct supervision, utilizing time constructively and organizing assignments for maximum productivity; arranges schedule to facilitate meetings with physicians for patient care rounds, team meetings and other opportunities to improve communication
• Adheres to name badge/dress code compliance

Utilization Management

• Knowledge of all applicable federal and state regulations; demonstrates a working knowledge of managed care and Medicare health plans as well as reimbursement related to post‑acute services within the continuum of care
• Consults with physician section leaders for support in cases that continued stay is not appropriate, and case manager is unable to come to resolution by working with assigned physician
• Responsible for communicating with the department director LOS and financial information, as well as issues that may affect the continuum of care process

Continuum of Care Planning

• The CM will be responsible for integrating the assessment of the need for post‑hospital services and determination of an appropriate discharge plan for complex cases
• Educates patient/family as to options/choices within the level of care determined to be appropriate; initiates and ensures completion of all necessary paperwork
• Facilitates completion of orders as required prior to transfer of patient to the next level of care in a timely manner so discharge is not delayed
• Continuum of Care planning will emphasize education and collaboration with physicians, family members, clinical social workers, nursing staff, therapists, and case managers from contracted payors when appropriate to determine discharge plan that will be of maximum benefit to the patient; involves staff from next level of care in the treatment plan as early as possible to promote continuity and collaboration
• Reports on all relevant information to the staff assuming responsibility in the next level of care
• Employees are expected to comply with all regulatory requirements, including CMS and Joint Commission Standards
• Must be able to functionally coordinate and discharge plan for all age groups, including but not limited to the unborn child through geriatric age groups

Risk Management

• Participates in departmental SQI projects
• Other Duties/Responsibilities
• Ability to effectively read, write, and speak, cognitively process and emotionally support performing other duties as assigned
• All employees are expected to remain flexible to meet the needs of the hospital

Required Qualifications

• Current, unrestricted Registered Nurse license in the state of Maine
• 3+ years of experience in a hospital, acute care, or direct care setting
• Intermediate level of proficiency to type and navigate a Windows based environment

Preferred Qualifications

• Bachelor's Degree (or higher) in Nursing (BSN)
• Case management experience
• Certified Case Manager (CCM) and/or American Case Management Certification (ACM)
• Experience or exposure to discharge planning
• Experience in utilization review and concurrent review
• Knowledge/understanding of community resources, policies, and procedures
• Knowledge of Utilization Review, Medicare Requirements processes as well as State and Federal regulations pertaining to Utilization Review and Discharge Planning
• Cerner EMR experience

Soft Skills

• Solid analytical, critical thinking and organizational skills

Pay and Benefits

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. The hourly pay for this role will range from $29.00 – $52.00 per hour based on full‑time employment. We comply with all minimum wage laws as applicable.

In addition to your salary, we offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution (all benefits are subject to eligibility requirements). The benefits include a broad range of medical, dental, vision, and other health‑related coverage.

Equal Employment Opportunity

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.

Eligibility

Candidates are required to pass a drug test before beginning employment.