Case Manager (CM) Coordination of patient services through an interdisciplinary process, which provides a clinical and psychosocial approach through the continuum of care Through case management, patients will be assessed to determine appropriateness of admission, continued hospitalization, as well as appropriate level of care Case Managers facilitate timely care delivery

Supervise Epic application design, development, maintenance activities of applications under direct purview Collaborate with end users to design Epic Revenue Cycle workflows by suggesting corrective adjustments or enhancements Determine staffing requirements, perform capacity planning for resources and supervise the work of direct reports to ensure that team is functionin

Support the full data engineering lifecycle including research, proof of concepts, design, development, testing, deployment, and maintenance of data management solutions Utilize knowledge of various data management technologies to drive data engineering projects Lead data acquisition efforts to gather data from various structured or semi structured source systems of recor

Lead and motivate a team of Clinical Consultant Pharmacists to deliver results Provides mentoring / coaching for Clinical Consultants in order to enhance employee engagement, promote professional development and maintain high levels of staff satisfaction Assist in the recruitment, on boarding and mentoring of new Clinical Consultant team members Determine and manage clini

Identify appropriate assignment of CPT and ICD 10 Codes for outpatient Ambulatory Same Day Surgery services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits Understand the Medicare Ambulatory Payment Classification (APC) codes A

Travel to provide skilled nursing care for infusion patients in their home and infusion suite Teach patients and their care givers to achieve the highest level of independence possible in self care and monitoring of their infusion therapy Assess the patients' condition and response to therapy, taking action as needed to facilitate achievement of treatment goals Collaborat

Provide clinical education and manage marketing services to hospital and physician referral sources to ensure awareness of Optum Specialty Pharmacy Infusion Services programs and services Assess and coordinate, in partnership with Case Managers and Discharge Planners, home infusion services to assist with determining the plan of care administered by Optum Specialty Pharma

Positions in this function perform various duties related to the fulfillment of prescription orders Dispense any or all of the following unit doses, specialty pharmaceuticals, injectables, IV, enterals and related supplies following state and federal regulations and company policies and procedures May compound medications using appropriate components, supplies and sterile

Leads new client onboarding and transformation by utilizing a diverse group of resources (people and technology) to integrate new clients into the standard OGOM Leads the PMO/PM discipline for technology implementations related to HB Coding Establish the standard HB Coding methodology to measure productivity, efficiency, scalability, human touch volume, and workflow Leads