RN Case Manager - ED - Remote in UT

The RN Case Manager - ED provides telephonic proactive case management services to members with frequent Emergency Department utilization, focusing on reducing avoidable ED visits and hospital admissions through early intervention, care coordination, and patient engagement.

• Pay: $72,800 - $130,000/year
• Location: Draper, UT
• Brand/Division: Optum
• Schedule: Full Time, Day shift

• Deploy RN case management support for identified high-risk and frequent ED utilizers within assigned markets
• Conduct comprehensive assessments to identify clinical, psychosocial, behavioral health, and social determinants of health needs
• Deliver proactive outreach, care coordination, and longitudinal member engagement to promote self-management and care plan adherence
• Reinforce primary care provider (PCP) engagement and facilitate timely follow-up appointments
• Provide education to members and caregivers regarding disease management, symptom recognition, medication adherence, and appropriate care settings
• Identify and address root causes of ED utilization, including care gaps, access barriers, social needs, and behavioral health concerns
• Connect members to appropriate programs and services, including Complex Case Management, Disease Management, Behavioral Health, Social Work, and community-based resources
• Utilize ED diversion strategies to support treatment in the most appropriate setting and prevent avoidable hospital admissions
• Monitor member progress and adjust interventions based on changing healthcare needs and risk factors
• Document all assessments, interventions, care plans, and outcomes in accordance with organizational and regulatory requirements

• Education: Bachelor's degree in nursing (BSN preferred)
• Experience: 3+ years of clinical nursing experience, preferably in acute care, care management, case management, utilization management, discharge planning, or transitional care
• Licenses &
  
  Certifications:
  
  Current, unrestricted Registered Nurse (RN) license in Utah

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