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Clinical Administrative Nurse

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Optum

Oct 16, 2024

Applications are closed

  • Job
    Full-time
    Senior Level
  • People, HR & Administration
    Healthcare
  • Eugene

Requirements

  • Graduate from an accredited school of nursing
  • Current Oregon Registered Nurse license
  • Current healthcare level BLS/CPR certification
  • 5+ years of professional nursing experience in a clinical, home care, medical/surgical, or ambulatory setting
  • Knowledge of Nursing theory and practice to give and evaluate patient care
  • Knowledge of community resources
  • Knowledge of organization policies, regulations and procedures to administer patient care
  • Knowledge of common safety hazards and precautions to establish a safe work environment
  • Good computer and typing skills
  • Demonstrated basic counseling skills and a positive, enthusiastic, and helpful personality to provide excellent patient service
  • Demonstrated skill in identifying problems and recommending solutions
  • Demonstrated skill in preparing and maintaining records, writing reports, and responding to inquiries
  • Demonstrated skill in developing and maintaining quality assurance
  • Demonstrated skill in establishing and maintaining effective working relationships with patients, medical staff and the public
  • Proven ability to react calmly and effectively in emergency situations
  • Proven ability to identify relevant internal policies and regulatory guidelines; establish/follow compliance procedures and enforce regulations and guidelines
  • Proven ability to complete applicable documentation (e.g., draft letters of denial/approval, member/provider contacts) following relevant internal and external regulations and guidelines
  • Proven ability to follow departmental processes (e.g., workflows, job aids); write and/or enforce policies to minimize risk and meet external regulatory requirement
  • Current Oregon driver license in good standing and reliable & insured transportation

Responsibilities

  • Assists with patient care needs and suggests solutions to patient care crisis problems. Participates in the case review process to resolve concerns regarding patient care, patient complaints, appeals and peer review
  • Clinical support and documentation of critical issues, e.g., communicable disease response, sterilization process and documentation, vaccine storage and management and clinic emergency bags
  • Assist Quality and Safety staff in problem solving and follow-up education needs. Participate in quality improvement activities as appropriate; identify problems and offer suggestions for improvement
  • Clinical Interface/Liaison (clinical problem solver with facilities, providers, carriers; 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 Training (planning, coordinating, delivering and evaluating clinical training)
  • Clinical Writing (writing nursing tools and reference information to support the design of clinical products and services)
  • 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
  • Serves as a role model for others through compliance with Optum Oregon policies, OSHA, and state/federal labor laws. Assists in the development and maintenance of regulatory initiatives, e.g., Accountable Care Act programs and requirements
  • Develops clinical policies and standards and ensures ongoing review of existing policies
  • Plans initial training and continuing education of clinical staff. Develops education and training for organizational program initiatives. Trains back office leads on their role as preceptors for the clinical staff and other clinical responsibilities. Plans and executes monthly Back Office Leadership meetings
  • Serves as a medico-legal resource to the organization. Documents all inquiries for medico-legal/statistical purposes
  • Participates in professional development activities to keep current with health care trends and practices
  • Maintains strictest confidentiality
  • Performs other duties as assigned

FAQs

What is the main role of a Clinical Administrative Nurse Consultant RN?

The main role is to coordinate services that improve the quality and efficiency of patient care, monitor outcomes, and assist clinical departments in providing safe, efficient, and evidence-based care.

What are the required qualifications for this position?

Required qualifications include a graduate from an accredited school of nursing, current Oregon Registered Nurse license, BLS/CPR certification, and 5+ years of professional nursing experience in various clinical settings.

Who does the Clinical Administrative Nurse report to?

The Clinical Administrative Nurse reports to the Director of Patient & Clinical Support.

Is there any supervision exercised in this role?

No, this role does not exercise supervision over others.

What are some primary responsibilities of this position?

Primary responsibilities include assisting with patient care needs, clinical support and documentation, participating in quality improvement activities, and developing clinical policies and standards.

What kind of work environment can be expected in this role?

The work environment is primarily an office setting, with regular telephone contact with clinical staff and providers regarding patient and clinical risk management issues.

What typical physical demands should candidates expect in this position?

Typical physical demands include sitting for long periods, occasional lifting of items up to 25 pounds, and the ability to react calmly in stressful situations.

Are there any continuing education opportunities for this role?

Yes, professional development activities are encouraged to keep current with healthcare trends and practices.

Is a valid driver’s license required for this position?

Yes, a current Oregon driver license in good standing, along with reliable and insured transportation, is required.

Is there a commitment to diversity and inclusion within the organization?

Yes, the organization is committed to diversity and equal employment opportunities, ensuring that all qualified applicants receive consideration without regard to various protected characteristics.

Science & Healthcare
Industry
10,001+
Employees

Mission & Purpose

Optum is a health services and technology company that provides a wide range of solutions to improve healthcare delivery and outcomes. They offer services in healthcare management, data analytics, pharmacy benefit management, and technology solutions to healthcare providers, payers, employers, and government agencies. Optum's ultimate mission is to improve the health system's efficiency and effectiveness, creating a healthier world for everyone. Their purpose lies in collaborating with healthcare partners to address complex challenges, such as improving care coordination, reducing healthcare costs, and enhancing patient experiences. By leveraging data-driven insights and innovative technology, Optum aims to empower healthcare professionals and organisations to deliver high-quality, patient-centered care and drive positive healthcare outcomes for individuals and communities worldwide.

Culture & Values

  • Integrity

    Honour commitments. Never compromise ethics.

  • Compassion

    Walk in the shoes of people we serve and those with whom we work.

  • Relationships

    Build trust through collaboration.

  • Innovation

    Invent the future, learn from the past.

  • Performance

    Demonstrate excellence in everything we do.