RN Case Manager

Optum AZ is seeking a RN Case Manager to join our team in Phoenix, AZ. This position provides clinical support to high‑risk patients within a primary care clinic and collaborates with multidisciplinary care teams. Primary Responsibilities Role embedded within the primary care clinic, working directly with patients, clinical and non‑clinical teams Participates in the identification of a focused clinic patient panel, as defined by the Chief Medical Officer Supports longitudinal care of the patient with chronic care conditions Communicates with patients, responding to patient questions via patient portal and other modalities Performs assessment of health conditions and implements care plan in collaboration with the member, caregiver(s), clinician(s), and/or other appropriate healthcare professionals to address needs and goals Pursues appropriate interventions to reduce risk of condition exacerbation, ER and hospitalization utilization Performs medication reconciliation and collaborates with clinician partner as needed Conducts Motivational Interviewing and Self‑Management Goal setting Provides patient education Creates referrals to appropriate agencies and resources Supports transition of care from Emergency Department or inpatient stay to outpatient setting Performs assessment of transitional needs Establishes and reviews contingency plan Assists with post‑discharge needs such as home health care, prescriptions, transportation, durable medical equipment (DME), appointments Coordinates with providers to establish or update individualized plan of care Creates referrals to appropriate internal and external resources Achieves quality measures outcomes via reduction in HEDIS gaps in care Performs accurate and timely documentation in the electronic medical record Performs triage and clinical tasks within scope of practice Participates in daily huddles and monthly clinic meetings, as required Prepares accurate and timely reports, as required Maintains continued competence in nursing practice and knowledge of current evidence‑based practices Performs ongoing updates of the care plan to evaluate effectiveness, and to document interventions and goal achievement Maintains a working knowledge of community resources Serves as facilitator and resource for other members of the medical group clinical team Attends departmental meetings and provides constructive recommendations for process improvement Performs other duties as assigned Required Qualifications Valid AZ RN license Current BLS certification 3+ years of job‑related experience in a healthcare environment Knowledge of medical terminology Proven skill with MS Office software applications Proven excellent communication, interpersonal, organization and customer service skills Proven self‑motivated, solid computer skills Proven attention to detail Proven ability to multi‑task and work under pressure Valid AZ state driver’s license and access to reliable transportation Preferred Qualifications Bachelor’s degree or higher in a healthcare‑related field 2+ years of experience providing prior authorization or case management within a health plan or integrated system Pay and Benefits Salary range: $60,200 – $107,400 annually for full‑time employment. Benefits include a comprehensive benefits package, equity stock purchase, 401(k) contribution, and incentive and recognition programs. Benefits are subject to eligibility requirements. We comply with all minimum wage laws as applicable. Equal Employment Opportunity Statement OptumCare 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, protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. Drug‑Free Workplace OptumCare is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment. #J-18808-Ljbffr