Senior Clinical Admin Consultant RN - Remote from Central Time Zone Preferred

Senior Clinical Admin Consultant RN

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Senior Clinical Admin Consultant RN is responsible for providing expertise as a clinical interface or liaison within the company to resolve and prevent issues concerning initiation and delivery of patient care. The CAC applies their field experience, expertise and clinical nursing assessment skills to: verify physician orders for therapy; determine administration method and patient supply requirements with the pharmacy team; determine nursing care needs and source for these services; coordinate care with subcontracted agencies, trouble shooting and resolving clinical issues, work in multiple applications at one time and execute all tasks with a focus on patient-specific needs.

The Senior Clinical Admin Consultant RN also performs other duties as needed based on experience level, including but not limited to implementing Company processes, programs, and new hire training.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Provide expertise as an internal clinical resource to operations teams (including other clinicians and subcontracted agencies) for evaluation of patient needs and/or issue resolution, exercising considerable judgment, problem solving skills, and professional knowledge
• Maintain a comprehensive knowledge base of infusion therapies administered in the home, utilizing Company policies, procedures and protocols in addition to all available training resources to ensure understanding of each therapy before initiating/coordinating treatment
• Completes clinical review of patient referral records and or telephonic data collection, including: current and past medical history; vascular access device (VAD) information; physician orders for appropriateness; ICD-10 code review; and documentation of nursing orders for start of care
• Provides timely communication with other company personnel and outside providers, especially physicians and home health agencies, to assure the quality and continuity of patient care
• Establish and maintain positive clinical rapport with subcontracted agencies, patients and their families, working closely with them in the coordination of infusion therapy, education related to self-care and self-administration expectations, and clinical monitoring of patient response to therapy
• Establish and maintain collaborative relationships with outside agencies and organizations that deliver service on behalf of, or in conjunction with, the Company (e.g., subcontracted home health agencies, durable medical equipment providers, other healthcare team members)
• Utilizes Electronic Medical Record (EMR) and documentation systems to clearly communicate patient status during clinical review, coordination of care and ongoing support of patients
• Participate in completion and tracking of timely signed receipt of physician orders (Plan of Treatment and Supplemental Orders)
• Work with patient care coordinators to triage patient calls to assess needs/issues/complaints/concerns: responding with appropriate urgency; thoroughly evaluating all options for addressing patient needs; and completing all required documentation to reflect actions taken
• Support field nursing staff with communication and follow-up required to resolve patient issues/complaints that are reported to the Company
• Maintain current nursing licensure in all states in which patients are serviced, as required by the respective State Boards of Nursing and/or Department of Health
• Comply with all State and Federal regulations and laws, including employee health and safety protections mandated by the Occupational Safety and Health Administration (OSHA), patient privacy and data security required by the Health Insurance Portability and Accountability Act (HIPAA), as well as all home infusion standards of practice
• Serve as a professional representative of the Company when meeting with and/or providing education to external customers, payers and referral sources
• Participate in medical record audits and other performance-improvement related activities as assigned by leadership
• Complete nurse competency yearly and providing educational reinforcement/ongoing assessment as needed to subcontracted agencies
• May be required to work any day or shift as needed
• Other duties as assigned

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:

• Active and unrestricted compact licensure as a Registered Nurse (RN) in the state(s) of practice and others as requested
• 2+ years of experience working as an RN in a clinical care setting that contributes to proficiency in infusion therapy (such as medical surgical unit, emergency department, intensive care unit, post-anesthesia care unit, or similar setting)
• 1+ years of experience working with interdisciplinary healthcare teams that included pharmacy, nursing, payers, case managers/discharge planners, physicians, patients and caregivers
• Experience with electronic medical records (EMR) programs and documentation
• Knowledge of and experience with Microsoft Office
• Proven willing and able to work with an interdisciplinary team of professionals including pharmacists and technicians, physicians and other licensed prescribers, registered dietitians, home health agencies (HHAs), sales representatives, and others as needed to provide comprehensive care and support of patients and caregivers
• Proven willing and able to work independently in home
• Proven willing and able to assume a flexible work schedule in meeting attendance, and other reliability requirements of the position
• Proven effective teaching skills
• Proven effective interpersonal communications, both written and verbal
• Proven excellent organizational and critical thinking skills

Preferred Qualifications:

• Infusion Therapy and/or Home Health Agency experience with specific proficiency in infusion therapy
• Experience within a healthcare organization providing coordination and navigation of patient care between providers
• Knowledgeable of HIPAA patient privacy and data security requirements, OSHA employee protection regulations, and The ACHC's accreditation standards for home health and home infusion pharmacy (and other relevant accrediting organizations, as applicable)
• Knowledge of and/or experience with current state licensure requirements
• Knowledge of the Infusion Nursing Society (INS) standards of practice, policies and procedures

VALUES BASED COMPETENCIES:

• Integrity Value: Model and Ensure Ethical Behavior
• Compassion Value: Deliver Value to Customers
• Relationships Value: Lead and Develop People
• Relationships Value: Communicate Effectively
• Innovation Value: Lead Change and Innovation
• Performance Value: Drive Sound, Disciplined Decisions
• Performance Value: Drive High-Quality Execution

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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,