Optum NY - Senior Clinical RN Liaison - remote

Senior Clinical Administrative RN Liaison

Optum NY, (formerly Optum Tri-State NY) is seeking a Senior Clinical Administrative RN Liaison to join our team in Poughkeepsie, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

The RN Post-Acute Liaison, in partnership with the Medical Management team and Physician Leadership, will serve as a clinical problem solver to ensure our patients receive care that is safe, high quality, patient-centered, and cost efficient. This includes collaborating with post-acute network facilities, vendors, and Optum partners on complex patient care coordination.

Primary Responsibilities:

• Clinical Liaison: Clinical problem solver with facilities, providers, resolution of issues concerning members, benefit interpretation, program definition and clarification
• Clinical Operations Analysis: Monitors and analyzes medical management activities; provides analytical support to clinical programs; may perform clinical assessments and clinical audits
• Clinical Program Management: Development, implementation and/or on-going management and administration of a clinical program(s). Provides strategic oversight and support, measurement standards and revisions as needed for delivery of programs focused on quality, affordability and outcomes
• Communicates with members of the Care Team as appropriate to coordinate the identified Member and physician's needs
• Provider/Member Education: Educate Member and care team participants on community/health plan benefit services available
• Performs various duties as needed to successfully fulfill the function of the position in conjunction with Medical Management as needed
• Identifies solutions to non-standard requests and problems
• Solves moderately complex problems and/or conducts moderately complex analyses
• Works with minimal guidance; seeks guidance on only the most complex tasks; Translates concepts into practice
• Provides explanations and information to others on difficult issues
• Provides feedback, and guides others
• Acts as a resource for others with less experience

Optum NY/NJ was formed in 2022 by bringing together Riverside Medical Group, CareMount Medical and ProHealth Care. The regional alignment combines resources and services across the care continuum - from preventative medicine to diagnostics to treatment and beyond across New York, New Jersey, and Southern Connecticut. As a Patient Centered Medical Home, Optum NY/NJ can provide patient-focused medical care to the entire family. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Together, we're making health care work better for everyone.

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:

• Bachelor's Degree or higher in Nursing
• Unrestricted current NY RN License
• 2+ years of experience as a nurse case manager
• 2+ years of experience managing complex disease cases
• Ability to travel within commutable distance of Poughkeepsie for internal and external on-site meetings 25% of the time

Preferred Qualifications:

• Certified Case Manager
• 5+ years of experience as a nurse case manager
• 5+ years of experience managing complex disease cases
• Experience coordinating patient care in the post-acute setting

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 $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.