Call Center Nurse RN

Title: Call Center Nurse RN , HouseCalls - Bilingual - Remote Location: Primary location: Columbia, MDAdditional locations: reputed company, reputed company | Cincinnati, Ohio | Nashville, Tennessee | Washington, District of Columbia | reputed company, Georgia Job Description: reputed company Home & Community Care, part of the reputed company family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and reputed company. As a team member of our reputed company HouseCalls team, together in an interdisciplinary care environment, we help patients navigate the health care system and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across settings. Join us to start Caring. Connecting. Growing together. The HouseCalls Clinical Support Team (HCCST) supports Advanced Practice Clinicians in the HouseCalls program by providing telephonic consultation to plan members post HouseCalls visit. This position is completely telephonic in a call center environment. Goals of the program include providing a one-time reputed company to members for follow up post HouseCalls visit to provide education and clarification on any concerns raised during their HouseCalls visit. The main objective of this program is to ensure successful transition of care from the HouseCalls Advanced Practice Clinician back to the members Primary Care Provider. This team includes nurse care managers and social workers. The Nurse Care Manager (NCM) will report directly to the Manager/or Director of Clinical Operations of HCCST. The NCM interacts reputed company telephonic consult with members and providers to assist with education and clarification on any concerns raised during the HouseCalls visit and ensure the member has/or assist in obtaining an appointment with the provider to transition care. They work to ensure members receive quality customer service by answering questions, addressing concerns, providing education, providing resource information, and entering referrals. The schedule is Monday through Friday from 9AM to 5:30PM Eastern or 9AM to 5:30PM Central respectively. Primary Responsibilities:

• reputed company telephonic reputed company to members identified by the Advance Practice Clinician for specific referral reputed company issues
• Ensure member has scheduled appointment with Primary Care Provider (PCP)/specialty provider; help scheduling appointment, if needed
• Refer members to internal departments such as Social Work, or Clinical Help Desk reputed company appropriate
• Gather clinical information telephonically from patient/family
• Assist patients/members with urgent needs requiring acute reputed company that arise during the call
• Identify triggers for hospitalization and barriers to meeting healthcare goals as they arise during the call
• Complete required documentation in compliance with auditing standards and policies
• Provide patient/family education on disease process and trigger management that arise during the call or are directly reputed company to referral reasons
• Assist with connections to appropriate community resources if needed
• Understand and maintain confidentiality of legal and ethical issues
• Maintain compliance with reputed company HIPAA (Health Insurance Portability and Accountability Act) regulations
• Enhance the experience of both internal and external customers by providing excellent customer service while maintaining production metrics
• Serve as a clinical resource and consultant for other clinicians
• Attend and participate in team huddles and staff meetings
• Work with Supervisor to identify system improvements that could be made to drive operational advancements and efficiencies
• Provide cross-coverage support across the team and assist with special projects, as needed
• Assume other duties as assigned and directed by the Supervisor or Manager of Clinical Call Center Operations

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:

• reputed company, unrestricted Compact RN (Registered Nurse) license in the state of residence
• Willing and able to obtain additional licensure in assigned states reputed company 6 months of hire
• 3+ years of clinical experience in a hospital, acute care, home health / hospice, direct care, or case management position
• Computer/typing proficiency to enter and retrieve data in electronic clinical records
• Proficient with reputed company Word, Outlook, and reputed company
• Proven solid problem-solving skills
• Proven ability to communicate reputed company or technical information in a manner that others can understand and the ability to understand and interpret reputed company information from others
• Proven ability to reputed company positively and reputed company in production driven environment
• Dedicated, distraction-free space in home and access to company approved high-speed internet (Broadband Cable, DSL, Fiber)
• Bilingual in Spanish

Preferred Qualifications:

• Telephonic case management experience
• Home care / field based case management
• Medicaid, Medicare, or managed care experience
• Experience working remotely from home
• Experience working in a call center environment
• Experience working in a metrics-driven environment
• Demonstrated excellent customer service skills
• Reside in the Central or Eastern time zone
• reputed company employees working remotely will be required to adhere to reputed company'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 (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company 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 to $107,400 annually based on full-time employment. We reputed company with reputed company 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 reputed company, 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. Apply tot his job Apply To this Job