Nurse Case Coordinator – Per Diem, Anywhere
2330458 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 a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Nurse Case Coordinator (NCC) is part of a dynamic team which works in collaboration with Physician Advisors and other departments within Optum Physician Advisor Solutions (OPAS). The Nurse Case Coordinator uses the Optum Clinical Group guidance (OCG) provided in order to ensure defensible and accurate case recommendationhss for concurrent admission, continued stay, and concurrent denial cases which are then reviewed by a Physician Advisor for completion of the concurrent and/or peer t peer review. They works directly with the Physician Advisors utilizing the guidance provided in order to make defensible and accurate case recommendations They coordinate key clinical findings, identifies high and low risks and proposes an initial case recommendation, supporting the clinical stay and/ or supporting a case through the concurrent denial process. They verify the accuracy and thoroughness of their work prior to sending the case to a physician for final review and case completion. The case is then submitted to a Physician Advisor for review completion. The Nurse Case Coordinator will maintain quality and productivity expectations. The Nurse Case Coordinator provides frontline customer service to clients and works in collaboration with other departments to ensure continuity of client care and satisfaction. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: The Nurse Case Coordinator accurately and efficiently reviews case details from patient records focusing on key elements according to process and following the OCG guidance. They completes cases in accordance with set productivity and quality expectations. The Nurse Case Coordinator performs job functions adhering to Optum Physician Advisor Solutions policies and procedures, which include but are not limited to the following: OPAS clinical database/clinical data entry