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Applied Researcher I (AI Foundations, LLM Customization, Finetuning, Reinforcement Learning)

Applied Researcher I (AI Foundations, LLM Customization, Finetuning, Reinforcement Learning) Overview: At Capital One, we are creating trustworthy and reliable AI systems, changing banking for good. For years, Capital One has been leading the industry in using machine learning to create real-time, intelligent, automated customer experiences. From informing customers about unusual charges to answering their questions in real time, our applications of AI & ML are bringing humanity and simplicity to banking. We are committed to building world-class applied science and engineering teams and continue our industry leading capabilities with breakthrough product experiences and scalable, high-performance AI infrastructure. At Capital One, you will help bring the transformative power of emerging AI capabilities to reimagine how we serve our customers and businesses who have come to love the products and services we build. Team Description: The AI Foundations team is at the center of bringing our vision for AI at Capital One to life. Our work touches every aspect of the research life cycle, from partnering with Academia to building production systems. We work with product, technology and business leaders to apply the state of the art in AI to our business. In this role, you will: Partner with a cross-functional team of data scientists, software engineers, machine learning engineers and product managers to deliver AI-powered products that change how customers interact with their money. Leverage a broad stack of technologies — Pytorch, AWS Ultraclusters, Huggingface, Lightning, VectorDBs, and more — to reveal the insights hidden within huge volumes of numeric and textual data. Build AI foundation models through all phases of development, from design through training, evaluation, validation, and implementation. Engage in high impact applied research to take the latest AI developments and push them into the next generation of customer experiences. Flex your interpersonal skills to translate the complexity of your work into tangible business goals. The Ideal Candidate: You love the process of analyzing and creating, but also share our passion to do the right thing. You know at the end of the day it’s about making the right decision for our customers. Innovative. You continually research and evaluate emerging technologies. You stay current on published state-of-the-art methods, technologies, and applications and seek out opportunities to apply them. Creative. You thrive on bringing definition to big, undefined problems. You love asking questions and pushing hard to find answers. You’re not afraid to share a new idea. A leader. You challenge conventional thinking and work with stakeholders to identify and improve the status quo. You’re passionate about talent development for your own team and beyond. Technical. You’re comfortable with open-source languages and are passionate about developing further. You have hands-on experience developing AI foundation models and solutions using open-source tools and cloud computing platforms. Has a deep understanding of the foundations of AI methodologies. Experience building large deep learning models, whether on language, images, events, or graphs, as well as expertise in one or more of the following: training optimization, self-supervised learning, robustness, explainability, RLHF. An engineering mindset as shown by a track record of delivering models at scale both in terms of training data and inference volumes. Experience in delivering libraries, platform level code or solution level code to existing products. A professional with a track record of coming up with high quality ideas or improving upon existing ideas in machine learning, demonstrated by accomplishments such as first author publications or projects. Possess the ability to own and pursue a research agenda, including choosing impactful research problems and autonomously carrying out long-running projects. Basic Qualifications: Currently has, or is in the process of obtaining, a PhD in Electrical Engineering, Computer Engineering, Computer Science, AI, Mathematics, or related fields, with an exception that required degree will be obtained on or before the scheduled start date or M.S. in Electrical Engineering, Computer Engineering, Computer Science, AI, Mathematics, or related fields plus 2 years of experience in Applied Research Preferred Qualifications: PhD in Computer Science, Machine Learning, Computer Engineering, Applied Mathematics, Electrical Engineering or related fields LLM PhD focus on NLP or Masters with 5 years of industrial NLP research experience Multiple publications on topics related to the pre-training of large language models (e.g. technical reports of pre-trained LLMs, SSL techniques, model pre-training optimization) Member of team that has trained a large language model from scratch (10B parameters, 500B tokens) Publications in deep learning theory Publications at ACL, NAACL and EMNLP, Neurips, ICML or ICLR Finetuning PhD focused on topics related to guiding LLMs with further tasks (Supervised Finetuning, Instruction-Tuning, Dialogue-Finetuning, Parameter Tuning) Demonstrated knowledge of principles of transfer learning, model adaptation and model guidance Experience deploying a fine-tuned large language model Data Preparation Publications studying tokenization, data quality, dataset curation, or labeling Contribution to a major open source corpus Contribution to open source libraries for data quality, dataset curation, or labeling Capital One will consider sponsoring a new qualified applicant for employment authorization for this position. The minimum and maximum full-time annual salaries for this role are listed below, by location. Please note that this salary information is solely for candidates hired to perform work within one of these locations, and refers to the amount Capital One is willing to pay at the time of this posting. Salaries for part-time roles will be prorated based upon the agreed upon number of hours to be regularly worked. Cambridge, MA: $218,700 - $249,600 for Applied Researcher I McLean, VA: $218,700 - $249,600 for Applied Researcher I New York, NY: $238,600 - $272,300 for Applied Researcher I San Jose, CA: $238,600 - $272,300 for Applied Researcher I Candidates hired to work in other locations will be subject to the pay range associated with that location, and the actual annualized salary amount offered to any candidate at the time of hire will be reflected solely in the candidate’s offer letter. This role is also eligible to earn performance based incentive compensation, which may include cash bonus(es) and/or long term incentives (LTI). Incentives could be discretionary or non discretionary depending on the plan. Capital One offers a comprehensive, competitive, and inclusive set of health, financial and other benefits that support your total well-being. Learn more at the Capital One Careers website . Eligibility varies based on full or part-time status, exempt or non-exempt status, and management level. This role is expected to accept applications for a minimum of 5 business days.No agencies please. Capital One is an equal opportunity employer (EOE, including disability/vet) committed to non-discrimination in compliance with applicable federal, state, and local laws. Capital One promotes a drug-free workplace. Capital One will consider for employment qualified applicants with a criminal history in a manner consistent with the requirements of applicable laws regarding criminal background inquiries, including, to the extent applicable, Article 23-A of the New York Correction Law; San Francisco, California Police Code Article 49, Sections 4901-4920; New York City’s Fair Chance Act; Philadelphia’s Fair Criminal Records Screening Act; and other applicable federal, state, and local laws and regulations regarding criminal background inquiries. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation, please contact Capital One Recruiting at 1-800-304-9102 or via email at [email protected] . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodations. For technical support or questions about Capital One's recruiting process, please send an email to [email protected] Capital One does not provide, endorse nor guarantee and is not liable for third-party products, services, educational tools or other information available through this site. Capital One Financial is made up of several different entities. Please note that any position posted in Canada is for Capital One Canada, any position posted in the United Kingdom is for Capital One Europe and any position posted in the Philippines is for Capital One Philippines Service Corp. (COPSSC).

  • Prince, NY

  • no content

Senior Lead AI Engineer (AI Foundations, LLM Core and Agentic AI)

Senior Lead AI Engineer (AI Foundations, LLM Core and Agentic AI) Overview: At Capital One, we are creating responsible and reliable AI systems, changing banking for good. For years, Capital One has been an industry leader in using machine learning to create real-time, personalized customer experiences. Our investments in technology infrastructure and world-class talent — along with our deep experience in machine learning — position us to be at the forefront of enterprises leveraging AI. From informing customers about unusual charges to answering their questions in real time, our applications of AI & ML are bringing humanity and simplicity to banking. We are committed to continuing to build world-class applied science and engineering teams to deliver our industry leading capabilities with breakthrough product experiences and scalable, high-performance AI infrastructure. At Capital One, you will help bring the transformative power of emerging AI capabilities to reimagine how we serve our customers and businesses who have come to love the products and services we build. Team Description: The Intelligent Foundations and Experiences (IFX) team is at the center of bringing our vision for AI at Capital One to life. We work hand-in-hand with our partners across the company to advance the state of the art in science and AI engineering, and we build and deploy proprietary solutions that are central to our business and deliver value to millions of customers. Our AI models and platforms empower teams across Capital One to enhance their products with the transformative power of AI, in responsible and scalable ways for the highest leverage impact. In this role, you will: Partner with a cross-functional team of engineers, research scientists, technical program managers, and product managers to deliver AI-powered products that change how our associates work and how our customers interact with Capital One. Design, develop, test, deploy, and support AI software components including foundation model training, large language model inference, similarity search, guardrails, model evaluation, experimentation, governance, and observability, etc. Leverage a broad stack of Open Source and SaaS AI technologies such as AWS Ultraclusters, Huggingface, VectorDBs, Nemo Guardrails, PyTorch, and more. Invent and introduce state-of-the-art LLM optimization techniques to improve the performance — scalability, cost, latency, throughput — of large scale production AI systems. Contribute to the technical vision and the long term roadmap of foundational AI systems at Capital One. The Ideal Candidate: You love to build systems, take pride in the quality of your work, and also share our passion to do the right thing. You want to work on problems that will help change banking for good. Passion for staying abreast of the latest research, and an ability to intuitively understand scientific publications and judiciously apply novel techniques in production. You adapt quickly and thrive on bringing clarity to big, undefined problems. You love asking questions and digging deep to uncover the root of problems and can articulate your findings concisely with clarity. You have the courage to share new ideas even when they are unproven. You are deeply Technical. You possess a strong foundation in engineering and mathematics, and your expertise in hardware, software, and AI enable you to see and exploit optimization opportunities that others miss. You are a resilient trail blazer who can forge new paths to achieve business goals when the route is unknown. Basic Qualifications: Bachelor's degree in Computer Science, AI, Electrical Engineering, Computer Engineering, or related fields plus at least 6 years of experience developing AI and ML algorithms or technologies, or a Master's degree in Computer Science, AI, Electrical Engineering, Computer Engineering, or related fields plus at least 4 years of experience developing AI and ML algorithms or technologies At least 6 years of experience programming with Python, Go, Scala, or Java Preferred Qualifications: 7 years of experience deploying scalable and responsible AI solutions on cloud platforms (e.g. AWS, Google Cloud, Azure, or equivalent private cloud) Experience designing, developing, integrating, delivering, and supporting complex AI systems Demonstrated ability to lead and mentor an engineering team and influence cross-functional stakeholders Experience developing AI and ML algorithms or technologies (e.g. LLM Inference, Similarity Search and VectorDBs, Guardrails, Memory) using Python, C++, C#, Java, or Golang Experience developing and applying state-of-the-art techniques for optimizing training and inference software to improve hardware utilization, latency, throughput, and cost Passion for staying abreast of the latest AI research and AI systems, and judiciously apply novel techniques in production Excellent communication and presentation skills, with the ability to articulate complex AI concepts to peers Capital One will consider sponsoring a new qualified applicant for employment authorization for this position. The minimum and maximum full-time annual salaries for this role are listed below, by location. Please note that this salary information is solely for candidates hired to perform work within one of these locations, and refers to the amount Capital One is willing to pay at the time of this posting. Salaries for part-time roles will be prorated based upon the agreed upon number of hours to be regularly worked. Cambridge, MA: $229,900 - $262,400 for Sr. Lead AI Engineer McLean, VA: $229,900 - $262,400 for Sr. Lead AI Engineer New York, NY: $250,800 - $286,200 for Sr. Lead AI Engineer San Francisco, CA: $250,800 - $286,200 for Sr. Lead AI Engineer San Jose, CA: $250,800 - $286,200 for Sr. Lead AI Engineer Candidates hired to work in other locations will be subject to the pay range associated with that location, and the actual annualized salary amount offered to any candidate at the time of hire will be reflected solely in the candidate’s offer letter. This role is also eligible to earn performance based incentive compensation, which may include cash bonus(es) and/or long term incentives (LTI). Incentives could be discretionary or non discretionary depending on the plan. Capital One offers a comprehensive, competitive, and inclusive set of health, financial and other benefits that support your total well-being. Learn more at the Capital One Careers website . Eligibility varies based on full or part-time status, exempt or non-exempt status, and management level. This role is expected to accept applications for a minimum of 5 business days.No agencies please. Capital One is an equal opportunity employer (EOE, including disability/vet) committed to non-discrimination in compliance with applicable federal, state, and local laws. Capital One promotes a drug-free workplace. Capital One will consider for employment qualified applicants with a criminal history in a manner consistent with the requirements of applicable laws regarding criminal background inquiries, including, to the extent applicable, Article 23-A of the New York Correction Law; San Francisco, California Police Code Article 49, Sections 4901-4920; New York City’s Fair Chance Act; Philadelphia’s Fair Criminal Records Screening Act; and other applicable federal, state, and local laws and regulations regarding criminal background inquiries. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation, please contact Capital One Recruiting at 1-800-304-9102 or via email at [email protected] . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodations. For technical support or questions about Capital One's recruiting process, please send an email to [email protected] Capital One does not provide, endorse nor guarantee and is not liable for third-party products, services, educational tools or other information available through this site. Capital One Financial is made up of several different entities. Please note that any position posted in Canada is for Capital One Canada, any position posted in the United Kingdom is for Capital One Europe and any position posted in the Philippines is for Capital One Philippines Service Corp. (COPSSC).

  • Prince, NY

  • no content

RN Enterprise Clinical Consultant Texas

WellMed, part of the Optum family of businesses, is seeking a Enterprise Clinical Consultant to join our team in Texas. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Enterprise Clinical Consultant is responsible for the management and supervision of all Homecare Dimensions Clinical Programs. They will implement and maintain performance improvement activities and maintains regulatory standards for the clinical programs across the branches. This Manager indirectly supervises all members of the branch staff and performs all functions in professional and ethical manner and collaborates with other members of the health care team to ensure quality patient care. The Enterprise Clinical Consultant will assure consistent, appropriate, and cost effective care by actively managing patient / client needs, payer's expectations, company policy compliance, and agency financial objectives. They will maintain accountability for achieving financial targets / profitability for the operation by empowering and challenging people, recruiting and training the best people, delivering quality in everything they do, providing the right incentives, providing the resources people need, and creating an environment that enables people to be successful. Primary Responsibilities: Directs the daily operations of Clinical Programs/ Operations to ensure the provision of safe, quality, cost-effective care to patients that contributes to the financial success of the branch Regularly evaluates the services and care provided by the branch to ensure compliance with regulatory requirements, company policies and procedures and sound business practices Directs the recruitment, hiring, and development of sufficient clinical and non-clinical staff to ensure the delivery of safe and consistent quality care to all patient/clients 24/ 7 Assures that clinical caregivers have demonstrated the ability to perform accurate and complete assessments, communicate with physicians, plan for service delivery, plan for discharge, and make excellent professional decisions Directs or delegates the assignment of staff, monitoring of daily and weekly schedules, and the matching of caregiver qualifications to patient/client needs, Manage quality through patient/client care appraisals and employee supervision Directs and participates in care coordination activities that effectively coordinate communication regarding patient/client problems, needs, psychosocial and spiritual concerns, and implementation of an individualized, interrelated plan of care Manages documentation to ensure that the patient/client's clinical record meets legal and regulatory requirements, facilitates care, enhances the continuity of care, helps coordinate treatment and evaluation of the patient/client, and establishes medical necessity so payers will reimburse for the services that are provided Develops and maintains a working knowledge of all services and resources available within the company and the community. Directs staff to meet patient/client needs through the identification and use of all available resources Responsible for interfacing with intake to assure that patient/client's are not admitted for clinical service (case accepted) until they have received an assessment visit and a determination has been made that they are appropriate for home care Responsible for annual evaluations of staff according to company policy and procedures and federal/state regulations Directs ongoing skill evaluations to assure that the staff's abilities are consistent with the needs of individual patient/clients and the marketplace Supervises clinical and operational processes by managing staff and ensuring flow of information and documentation from inquiry through discharge of all patient/clients Provides support and documentation needed to facilitate reimbursement Assists with the development of an annual market assessment, budget, and business plan and monitors expenditures and adherence to company policies through the implementation of controls Assists the Vice President with assessing business opportunities and provides information on costs that can be used in determining the feasibility of pursuing local managed care opportunities. When directed, gathers information about marketplace pay and bill rates Schedules staff meetings to communicate with employees, caregivers when appropriate, regarding the needs and concerns of patient/clients and their families, referral sources, clinical updates, policy and procedure changes, and payer sources and the potential for business that these customers represent Discusses operational issues to identify issues that may compromise optimal service to customers Employs marketing and promotional efforts within the community to support the achievement of new and existing programs Implements and maintains Quality Assurance Performance Improvement for the branch by participating in Quality Assessment and Improvement and CHAPs activities and assures participation of all appropriate staff Provides information that enables the collection and root-cause analysis of data to identify opportunities for improvement, develops/oversees the development and implementation of action plans that result in continuous quality improvement Oversees branch operations and makes adjustments where needed to increase the overall efficiency of the department Investigates complaints and incidents, and oversees and appropriate outcome/ resolution Submits reports on or before deadline dates Provides back up support and handles other functional role responsibilities, as required, to assure that operational needs are met In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000 primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000 older adults. Together, we're making health care work better for everyone. 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: Bachelor degree in health or business administration (four additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor's Degree) Registered Nurse with 6 years of experience in a clinical leadership / management role Recent experience in acute care or home care (within last 2 years) Working knowledge of governmental home health agency regulations, Medicare (Medicaid, as required), regulations and company policies and procedures Solid organizational, communication, interpersonal skills and reliable transportation This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease Preferred Qualifications: Experience in a community health or home health setting Demonstrated decision-making skills and strong judgment Bilingual speaking (English/Spanish) Physical and Mental Requirements: Ability to lift up to fifty (50) pounds (must be able to lift and transfer patients from one location to another, if necessary Ability to push/pull heavy objects using up to fifty (50) pounds of force Ability to sit for extended periods of time Ability to stand for extended period of time Ability to use fine motor skills to operate office equipment and/or machinery Ability to properly drive and operate a personal/company vehicle Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex situations 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 (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all 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 origin, 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.

  • Timberwood Park, TX

  • no content

RN Enterprise Clinical Consultant Texas

WellMed, part of the Optum family of businesses, is seeking a Enterprise Clinical Consultant to join our team in Texas. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Enterprise Clinical Consultant is responsible for the management and supervision of all Homecare Dimensions Clinical Programs. They will implement and maintain performance improvement activities and maintains regulatory standards for the clinical programs across the branches. This Manager indirectly supervises all members of the branch staff and performs all functions in professional and ethical manner and collaborates with other members of the health care team to ensure quality patient care. The Enterprise Clinical Consultant will assure consistent, appropriate, and cost effective care by actively managing patient / client needs, payer's expectations, company policy compliance, and agency financial objectives. They will maintain accountability for achieving financial targets / profitability for the operation by empowering and challenging people, recruiting and training the best people, delivering quality in everything they do, providing the right incentives, providing the resources people need, and creating an environment that enables people to be successful. Primary Responsibilities: Directs the daily operations of Clinical Programs/ Operations to ensure the provision of safe, quality, cost-effective care to patients that contributes to the financial success of the branch Regularly evaluates the services and care provided by the branch to ensure compliance with regulatory requirements, company policies and procedures and sound business practices Directs the recruitment, hiring, and development of sufficient clinical and non-clinical staff to ensure the delivery of safe and consistent quality care to all patient/clients 24/ 7 Assures that clinical caregivers have demonstrated the ability to perform accurate and complete assessments, communicate with physicians, plan for service delivery, plan for discharge, and make excellent professional decisions Directs or delegates the assignment of staff, monitoring of daily and weekly schedules, and the matching of caregiver qualifications to patient/client needs, Manage quality through patient/client care appraisals and employee supervision Directs and participates in care coordination activities that effectively coordinate communication regarding patient/client problems, needs, psychosocial and spiritual concerns, and implementation of an individualized, interrelated plan of care Manages documentation to ensure that the patient/client's clinical record meets legal and regulatory requirements, facilitates care, enhances the continuity of care, helps coordinate treatment and evaluation of the patient/client, and establishes medical necessity so payers will reimburse for the services that are provided Develops and maintains a working knowledge of all services and resources available within the company and the community. Directs staff to meet patient/client needs through the identification and use of all available resources Responsible for interfacing with intake to assure that patient/client's are not admitted for clinical service (case accepted) until they have received an assessment visit and a determination has been made that they are appropriate for home care Responsible for annual evaluations of staff according to company policy and procedures and federal/state regulations Directs ongoing skill evaluations to assure that the staff's abilities are consistent with the needs of individual patient/clients and the marketplace Supervises clinical and operational processes by managing staff and ensuring flow of information and documentation from inquiry through discharge of all patient/clients Provides support and documentation needed to facilitate reimbursement Assists with the development of an annual market assessment, budget, and business plan and monitors expenditures and adherence to company policies through the implementation of controls Assists the Vice President with assessing business opportunities and provides information on costs that can be used in determining the feasibility of pursuing local managed care opportunities. When directed, gathers information about marketplace pay and bill rates Schedules staff meetings to communicate with employees, caregivers when appropriate, regarding the needs and concerns of patient/clients and their families, referral sources, clinical updates, policy and procedure changes, and payer sources and the potential for business that these customers represent Discusses operational issues to identify issues that may compromise optimal service to customers Employs marketing and promotional efforts within the community to support the achievement of new and existing programs Implements and maintains Quality Assurance Performance Improvement for the branch by participating in Quality Assessment and Improvement and CHAPs activities and assures participation of all appropriate staff Provides information that enables the collection and root-cause analysis of data to identify opportunities for improvement, develops/oversees the development and implementation of action plans that result in continuous quality improvement Oversees branch operations and makes adjustments where needed to increase the overall efficiency of the department Investigates complaints and incidents, and oversees and appropriate outcome/ resolution Submits reports on or before deadline dates Provides back up support and handles other functional role responsibilities, as required, to assure that operational needs are met In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000 primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000 older adults. Together, we're making health care work better for everyone. 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: Bachelor degree in health or business administration (four additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor's Degree) Registered Nurse with 6 years of experience in a clinical leadership / management role Recent experience in acute care or home care (within last 2 years) Working knowledge of governmental home health agency regulations, Medicare (Medicaid, as required), regulations and company policies and procedures Solid organizational, communication, interpersonal skills and reliable transportation This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease Preferred Qualifications: Experience in a community health or home health setting Demonstrated decision-making skills and strong judgment Bilingual speaking (English/Spanish) Physical and Mental Requirements: Ability to lift up to fifty (50) pounds (must be able to lift and transfer patients from one location to another, if necessary Ability to push/pull heavy objects using up to fifty (50) pounds of force Ability to sit for extended periods of time Ability to stand for extended period of time Ability to use fine motor skills to operate office equipment and/or machinery Ability to properly drive and operate a personal/company vehicle Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex situations 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 (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all 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 origin, 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.

  • Leming, TX

  • no content

RN Enterprise Clinical Consultant Texas

WellMed, part of the Optum family of businesses, is seeking a Enterprise Clinical Consultant to join our team in Texas. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Enterprise Clinical Consultant is responsible for the management and supervision of all Homecare Dimensions Clinical Programs. They will implement and maintain performance improvement activities and maintains regulatory standards for the clinical programs across the branches. This Manager indirectly supervises all members of the branch staff and performs all functions in professional and ethical manner and collaborates with other members of the health care team to ensure quality patient care. The Enterprise Clinical Consultant will assure consistent, appropriate, and cost effective care by actively managing patient / client needs, payer's expectations, company policy compliance, and agency financial objectives. They will maintain accountability for achieving financial targets / profitability for the operation by empowering and challenging people, recruiting and training the best people, delivering quality in everything they do, providing the right incentives, providing the resources people need, and creating an environment that enables people to be successful. Primary Responsibilities: Directs the daily operations of Clinical Programs/ Operations to ensure the provision of safe, quality, cost-effective care to patients that contributes to the financial success of the branch Regularly evaluates the services and care provided by the branch to ensure compliance with regulatory requirements, company policies and procedures and sound business practices Directs the recruitment, hiring, and development of sufficient clinical and non-clinical staff to ensure the delivery of safe and consistent quality care to all patient/clients 24/ 7 Assures that clinical caregivers have demonstrated the ability to perform accurate and complete assessments, communicate with physicians, plan for service delivery, plan for discharge, and make excellent professional decisions Directs or delegates the assignment of staff, monitoring of daily and weekly schedules, and the matching of caregiver qualifications to patient/client needs, Manage quality through patient/client care appraisals and employee supervision Directs and participates in care coordination activities that effectively coordinate communication regarding patient/client problems, needs, psychosocial and spiritual concerns, and implementation of an individualized, interrelated plan of care Manages documentation to ensure that the patient/client's clinical record meets legal and regulatory requirements, facilitates care, enhances the continuity of care, helps coordinate treatment and evaluation of the patient/client, and establishes medical necessity so payers will reimburse for the services that are provided Develops and maintains a working knowledge of all services and resources available within the company and the community. Directs staff to meet patient/client needs through the identification and use of all available resources Responsible for interfacing with intake to assure that patient/client's are not admitted for clinical service (case accepted) until they have received an assessment visit and a determination has been made that they are appropriate for home care Responsible for annual evaluations of staff according to company policy and procedures and federal/state regulations Directs ongoing skill evaluations to assure that the staff's abilities are consistent with the needs of individual patient/clients and the marketplace Supervises clinical and operational processes by managing staff and ensuring flow of information and documentation from inquiry through discharge of all patient/clients Provides support and documentation needed to facilitate reimbursement Assists with the development of an annual market assessment, budget, and business plan and monitors expenditures and adherence to company policies through the implementation of controls Assists the Vice President with assessing business opportunities and provides information on costs that can be used in determining the feasibility of pursuing local managed care opportunities. When directed, gathers information about marketplace pay and bill rates Schedules staff meetings to communicate with employees, caregivers when appropriate, regarding the needs and concerns of patient/clients and their families, referral sources, clinical updates, policy and procedure changes, and payer sources and the potential for business that these customers represent Discusses operational issues to identify issues that may compromise optimal service to customers Employs marketing and promotional efforts within the community to support the achievement of new and existing programs Implements and maintains Quality Assurance Performance Improvement for the branch by participating in Quality Assessment and Improvement and CHAPs activities and assures participation of all appropriate staff Provides information that enables the collection and root-cause analysis of data to identify opportunities for improvement, develops/oversees the development and implementation of action plans that result in continuous quality improvement Oversees branch operations and makes adjustments where needed to increase the overall efficiency of the department Investigates complaints and incidents, and oversees and appropriate outcome/ resolution Submits reports on or before deadline dates Provides back up support and handles other functional role responsibilities, as required, to assure that operational needs are met In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000 primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000 older adults. Together, we're making health care work better for everyone. 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: Bachelor degree in health or business administration (four additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor's Degree) Registered Nurse with 6 years of experience in a clinical leadership / management role Recent experience in acute care or home care (within last 2 years) Working knowledge of governmental home health agency regulations, Medicare (Medicaid, as required), regulations and company policies and procedures Solid organizational, communication, interpersonal skills and reliable transportation This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease Preferred Qualifications: Experience in a community health or home health setting Demonstrated decision-making skills and strong judgment Bilingual speaking (English/Spanish) Physical and Mental Requirements: Ability to lift up to fifty (50) pounds (must be able to lift and transfer patients from one location to another, if necessary Ability to push/pull heavy objects using up to fifty (50) pounds of force Ability to sit for extended periods of time Ability to stand for extended period of time Ability to use fine motor skills to operate office equipment and/or machinery Ability to properly drive and operate a personal/company vehicle Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex situations 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 (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all 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 origin, 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.

  • Shavano Park, TX

  • no content

RN Enterprise Clinical Consultant Texas

WellMed, part of the Optum family of businesses, is seeking a Enterprise Clinical Consultant to join our team in Texas. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Enterprise Clinical Consultant is responsible for the management and supervision of all Homecare Dimensions Clinical Programs. They will implement and maintain performance improvement activities and maintains regulatory standards for the clinical programs across the branches. This Manager indirectly supervises all members of the branch staff and performs all functions in professional and ethical manner and collaborates with other members of the health care team to ensure quality patient care. The Enterprise Clinical Consultant will assure consistent, appropriate, and cost effective care by actively managing patient / client needs, payer's expectations, company policy compliance, and agency financial objectives. They will maintain accountability for achieving financial targets / profitability for the operation by empowering and challenging people, recruiting and training the best people, delivering quality in everything they do, providing the right incentives, providing the resources people need, and creating an environment that enables people to be successful. Primary Responsibilities: Directs the daily operations of Clinical Programs/ Operations to ensure the provision of safe, quality, cost-effective care to patients that contributes to the financial success of the branch Regularly evaluates the services and care provided by the branch to ensure compliance with regulatory requirements, company policies and procedures and sound business practices Directs the recruitment, hiring, and development of sufficient clinical and non-clinical staff to ensure the delivery of safe and consistent quality care to all patient/clients 24/ 7 Assures that clinical caregivers have demonstrated the ability to perform accurate and complete assessments, communicate with physicians, plan for service delivery, plan for discharge, and make excellent professional decisions Directs or delegates the assignment of staff, monitoring of daily and weekly schedules, and the matching of caregiver qualifications to patient/client needs, Manage quality through patient/client care appraisals and employee supervision Directs and participates in care coordination activities that effectively coordinate communication regarding patient/client problems, needs, psychosocial and spiritual concerns, and implementation of an individualized, interrelated plan of care Manages documentation to ensure that the patient/client's clinical record meets legal and regulatory requirements, facilitates care, enhances the continuity of care, helps coordinate treatment and evaluation of the patient/client, and establishes medical necessity so payers will reimburse for the services that are provided Develops and maintains a working knowledge of all services and resources available within the company and the community. Directs staff to meet patient/client needs through the identification and use of all available resources Responsible for interfacing with intake to assure that patient/client's are not admitted for clinical service (case accepted) until they have received an assessment visit and a determination has been made that they are appropriate for home care Responsible for annual evaluations of staff according to company policy and procedures and federal/state regulations Directs ongoing skill evaluations to assure that the staff's abilities are consistent with the needs of individual patient/clients and the marketplace Supervises clinical and operational processes by managing staff and ensuring flow of information and documentation from inquiry through discharge of all patient/clients Provides support and documentation needed to facilitate reimbursement Assists with the development of an annual market assessment, budget, and business plan and monitors expenditures and adherence to company policies through the implementation of controls Assists the Vice President with assessing business opportunities and provides information on costs that can be used in determining the feasibility of pursuing local managed care opportunities. When directed, gathers information about marketplace pay and bill rates Schedules staff meetings to communicate with employees, caregivers when appropriate, regarding the needs and concerns of patient/clients and their families, referral sources, clinical updates, policy and procedure changes, and payer sources and the potential for business that these customers represent Discusses operational issues to identify issues that may compromise optimal service to customers Employs marketing and promotional efforts within the community to support the achievement of new and existing programs Implements and maintains Quality Assurance Performance Improvement for the branch by participating in Quality Assessment and Improvement and CHAPs activities and assures participation of all appropriate staff Provides information that enables the collection and root-cause analysis of data to identify opportunities for improvement, develops/oversees the development and implementation of action plans that result in continuous quality improvement Oversees branch operations and makes adjustments where needed to increase the overall efficiency of the department Investigates complaints and incidents, and oversees and appropriate outcome/ resolution Submits reports on or before deadline dates Provides back up support and handles other functional role responsibilities, as required, to assure that operational needs are met In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000 primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000 older adults. Together, we're making health care work better for everyone. 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: Bachelor degree in health or business administration (four additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor's Degree) Registered Nurse with 6 years of experience in a clinical leadership / management role Recent experience in acute care or home care (within last 2 years) Working knowledge of governmental home health agency regulations, Medicare (Medicaid, as required), regulations and company policies and procedures Solid organizational, communication, interpersonal skills and reliable transportation This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease Preferred Qualifications: Experience in a community health or home health setting Demonstrated decision-making skills and strong judgment Bilingual speaking (English/Spanish) Physical and Mental Requirements: Ability to lift up to fifty (50) pounds (must be able to lift and transfer patients from one location to another, if necessary Ability to push/pull heavy objects using up to fifty (50) pounds of force Ability to sit for extended periods of time Ability to stand for extended period of time Ability to use fine motor skills to operate office equipment and/or machinery Ability to properly drive and operate a personal/company vehicle Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex situations 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 (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all 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 origin, 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.

  • Cost, TX

  • no content

RN Enterprise Clinical Consultant Texas

WellMed, part of the Optum family of businesses, is seeking a Enterprise Clinical Consultant to join our team in Texas. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Enterprise Clinical Consultant is responsible for the management and supervision of all Homecare Dimensions Clinical Programs. They will implement and maintain performance improvement activities and maintains regulatory standards for the clinical programs across the branches. This Manager indirectly supervises all members of the branch staff and performs all functions in professional and ethical manner and collaborates with other members of the health care team to ensure quality patient care. The Enterprise Clinical Consultant will assure consistent, appropriate, and cost effective care by actively managing patient / client needs, payer's expectations, company policy compliance, and agency financial objectives. They will maintain accountability for achieving financial targets / profitability for the operation by empowering and challenging people, recruiting and training the best people, delivering quality in everything they do, providing the right incentives, providing the resources people need, and creating an environment that enables people to be successful. Primary Responsibilities: Directs the daily operations of Clinical Programs/ Operations to ensure the provision of safe, quality, cost-effective care to patients that contributes to the financial success of the branch Regularly evaluates the services and care provided by the branch to ensure compliance with regulatory requirements, company policies and procedures and sound business practices Directs the recruitment, hiring, and development of sufficient clinical and non-clinical staff to ensure the delivery of safe and consistent quality care to all patient/clients 24/ 7 Assures that clinical caregivers have demonstrated the ability to perform accurate and complete assessments, communicate with physicians, plan for service delivery, plan for discharge, and make excellent professional decisions Directs or delegates the assignment of staff, monitoring of daily and weekly schedules, and the matching of caregiver qualifications to patient/client needs, Manage quality through patient/client care appraisals and employee supervision Directs and participates in care coordination activities that effectively coordinate communication regarding patient/client problems, needs, psychosocial and spiritual concerns, and implementation of an individualized, interrelated plan of care Manages documentation to ensure that the patient/client's clinical record meets legal and regulatory requirements, facilitates care, enhances the continuity of care, helps coordinate treatment and evaluation of the patient/client, and establishes medical necessity so payers will reimburse for the services that are provided Develops and maintains a working knowledge of all services and resources available within the company and the community. Directs staff to meet patient/client needs through the identification and use of all available resources Responsible for interfacing with intake to assure that patient/client's are not admitted for clinical service (case accepted) until they have received an assessment visit and a determination has been made that they are appropriate for home care Responsible for annual evaluations of staff according to company policy and procedures and federal/state regulations Directs ongoing skill evaluations to assure that the staff's abilities are consistent with the needs of individual patient/clients and the marketplace Supervises clinical and operational processes by managing staff and ensuring flow of information and documentation from inquiry through discharge of all patient/clients Provides support and documentation needed to facilitate reimbursement Assists with the development of an annual market assessment, budget, and business plan and monitors expenditures and adherence to company policies through the implementation of controls Assists the Vice President with assessing business opportunities and provides information on costs that can be used in determining the feasibility of pursuing local managed care opportunities. When directed, gathers information about marketplace pay and bill rates Schedules staff meetings to communicate with employees, caregivers when appropriate, regarding the needs and concerns of patient/clients and their families, referral sources, clinical updates, policy and procedure changes, and payer sources and the potential for business that these customers represent Discusses operational issues to identify issues that may compromise optimal service to customers Employs marketing and promotional efforts within the community to support the achievement of new and existing programs Implements and maintains Quality Assurance Performance Improvement for the branch by participating in Quality Assessment and Improvement and CHAPs activities and assures participation of all appropriate staff Provides information that enables the collection and root-cause analysis of data to identify opportunities for improvement, develops/oversees the development and implementation of action plans that result in continuous quality improvement Oversees branch operations and makes adjustments where needed to increase the overall efficiency of the department Investigates complaints and incidents, and oversees and appropriate outcome/ resolution Submits reports on or before deadline dates Provides back up support and handles other functional role responsibilities, as required, to assure that operational needs are met In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000 primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000 older adults. Together, we're making health care work better for everyone. 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: Bachelor degree in health or business administration (four additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor's Degree) Registered Nurse with 6 years of experience in a clinical leadership / management role Recent experience in acute care or home care (within last 2 years) Working knowledge of governmental home health agency regulations, Medicare (Medicaid, as required), regulations and company policies and procedures Solid organizational, communication, interpersonal skills and reliable transportation This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease Preferred Qualifications: Experience in a community health or home health setting Demonstrated decision-making skills and strong judgment Bilingual speaking (English/Spanish) Physical and Mental Requirements: Ability to lift up to fifty (50) pounds (must be able to lift and transfer patients from one location to another, if necessary Ability to push/pull heavy objects using up to fifty (50) pounds of force Ability to sit for extended periods of time Ability to stand for extended period of time Ability to use fine motor skills to operate office equipment and/or machinery Ability to properly drive and operate a personal/company vehicle Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex situations 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 (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all 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 origin, 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.

  • Terrell Hills, TX

  • no content

RN Enterprise Clinical Consultant Texas

WellMed, part of the Optum family of businesses, is seeking a Enterprise Clinical Consultant to join our team in Texas. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Enterprise Clinical Consultant is responsible for the management and supervision of all Homecare Dimensions Clinical Programs. They will implement and maintain performance improvement activities and maintains regulatory standards for the clinical programs across the branches. This Manager indirectly supervises all members of the branch staff and performs all functions in professional and ethical manner and collaborates with other members of the health care team to ensure quality patient care. The Enterprise Clinical Consultant will assure consistent, appropriate, and cost effective care by actively managing patient / client needs, payer's expectations, company policy compliance, and agency financial objectives. They will maintain accountability for achieving financial targets / profitability for the operation by empowering and challenging people, recruiting and training the best people, delivering quality in everything they do, providing the right incentives, providing the resources people need, and creating an environment that enables people to be successful. Primary Responsibilities: Directs the daily operations of Clinical Programs/ Operations to ensure the provision of safe, quality, cost-effective care to patients that contributes to the financial success of the branch Regularly evaluates the services and care provided by the branch to ensure compliance with regulatory requirements, company policies and procedures and sound business practices Directs the recruitment, hiring, and development of sufficient clinical and non-clinical staff to ensure the delivery of safe and consistent quality care to all patient/clients 24/ 7 Assures that clinical caregivers have demonstrated the ability to perform accurate and complete assessments, communicate with physicians, plan for service delivery, plan for discharge, and make excellent professional decisions Directs or delegates the assignment of staff, monitoring of daily and weekly schedules, and the matching of caregiver qualifications to patient/client needs, Manage quality through patient/client care appraisals and employee supervision Directs and participates in care coordination activities that effectively coordinate communication regarding patient/client problems, needs, psychosocial and spiritual concerns, and implementation of an individualized, interrelated plan of care Manages documentation to ensure that the patient/client's clinical record meets legal and regulatory requirements, facilitates care, enhances the continuity of care, helps coordinate treatment and evaluation of the patient/client, and establishes medical necessity so payers will reimburse for the services that are provided Develops and maintains a working knowledge of all services and resources available within the company and the community. Directs staff to meet patient/client needs through the identification and use of all available resources Responsible for interfacing with intake to assure that patient/client's are not admitted for clinical service (case accepted) until they have received an assessment visit and a determination has been made that they are appropriate for home care Responsible for annual evaluations of staff according to company policy and procedures and federal/state regulations Directs ongoing skill evaluations to assure that the staff's abilities are consistent with the needs of individual patient/clients and the marketplace Supervises clinical and operational processes by managing staff and ensuring flow of information and documentation from inquiry through discharge of all patient/clients Provides support and documentation needed to facilitate reimbursement Assists with the development of an annual market assessment, budget, and business plan and monitors expenditures and adherence to company policies through the implementation of controls Assists the Vice President with assessing business opportunities and provides information on costs that can be used in determining the feasibility of pursuing local managed care opportunities. When directed, gathers information about marketplace pay and bill rates Schedules staff meetings to communicate with employees, caregivers when appropriate, regarding the needs and concerns of patient/clients and their families, referral sources, clinical updates, policy and procedure changes, and payer sources and the potential for business that these customers represent Discusses operational issues to identify issues that may compromise optimal service to customers Employs marketing and promotional efforts within the community to support the achievement of new and existing programs Implements and maintains Quality Assurance Performance Improvement for the branch by participating in Quality Assessment and Improvement and CHAPs activities and assures participation of all appropriate staff Provides information that enables the collection and root-cause analysis of data to identify opportunities for improvement, develops/oversees the development and implementation of action plans that result in continuous quality improvement Oversees branch operations and makes adjustments where needed to increase the overall efficiency of the department Investigates complaints and incidents, and oversees and appropriate outcome/ resolution Submits reports on or before deadline dates Provides back up support and handles other functional role responsibilities, as required, to assure that operational needs are met In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000 primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000 older adults. Together, we're making health care work better for everyone. 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: Bachelor degree in health or business administration (four additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor's Degree) Registered Nurse with 6 years of experience in a clinical leadership / management role Recent experience in acute care or home care (within last 2 years) Working knowledge of governmental home health agency regulations, Medicare (Medicaid, as required), regulations and company policies and procedures Solid organizational, communication, interpersonal skills and reliable transportation This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease Preferred Qualifications: Experience in a community health or home health setting Demonstrated decision-making skills and strong judgment Bilingual speaking (English/Spanish) Physical and Mental Requirements: Ability to lift up to fifty (50) pounds (must be able to lift and transfer patients from one location to another, if necessary Ability to push/pull heavy objects using up to fifty (50) pounds of force Ability to sit for extended periods of time Ability to stand for extended period of time Ability to use fine motor skills to operate office equipment and/or machinery Ability to properly drive and operate a personal/company vehicle Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex situations 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 (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all 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 origin, 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.

  • Smiley, TX

  • no content

RN Enterprise Clinical Consultant Texas

WellMed, part of the Optum family of businesses, is seeking a Enterprise Clinical Consultant to join our team in Texas. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Enterprise Clinical Consultant is responsible for the management and supervision of all Homecare Dimensions Clinical Programs. They will implement and maintain performance improvement activities and maintains regulatory standards for the clinical programs across the branches. This Manager indirectly supervises all members of the branch staff and performs all functions in professional and ethical manner and collaborates with other members of the health care team to ensure quality patient care. The Enterprise Clinical Consultant will assure consistent, appropriate, and cost effective care by actively managing patient / client needs, payer's expectations, company policy compliance, and agency financial objectives. They will maintain accountability for achieving financial targets / profitability for the operation by empowering and challenging people, recruiting and training the best people, delivering quality in everything they do, providing the right incentives, providing the resources people need, and creating an environment that enables people to be successful. Primary Responsibilities: Directs the daily operations of Clinical Programs/ Operations to ensure the provision of safe, quality, cost-effective care to patients that contributes to the financial success of the branch Regularly evaluates the services and care provided by the branch to ensure compliance with regulatory requirements, company policies and procedures and sound business practices Directs the recruitment, hiring, and development of sufficient clinical and non-clinical staff to ensure the delivery of safe and consistent quality care to all patient/clients 24/ 7 Assures that clinical caregivers have demonstrated the ability to perform accurate and complete assessments, communicate with physicians, plan for service delivery, plan for discharge, and make excellent professional decisions Directs or delegates the assignment of staff, monitoring of daily and weekly schedules, and the matching of caregiver qualifications to patient/client needs, Manage quality through patient/client care appraisals and employee supervision Directs and participates in care coordination activities that effectively coordinate communication regarding patient/client problems, needs, psychosocial and spiritual concerns, and implementation of an individualized, interrelated plan of care Manages documentation to ensure that the patient/client's clinical record meets legal and regulatory requirements, facilitates care, enhances the continuity of care, helps coordinate treatment and evaluation of the patient/client, and establishes medical necessity so payers will reimburse for the services that are provided Develops and maintains a working knowledge of all services and resources available within the company and the community. Directs staff to meet patient/client needs through the identification and use of all available resources Responsible for interfacing with intake to assure that patient/client's are not admitted for clinical service (case accepted) until they have received an assessment visit and a determination has been made that they are appropriate for home care Responsible for annual evaluations of staff according to company policy and procedures and federal/state regulations Directs ongoing skill evaluations to assure that the staff's abilities are consistent with the needs of individual patient/clients and the marketplace Supervises clinical and operational processes by managing staff and ensuring flow of information and documentation from inquiry through discharge of all patient/clients Provides support and documentation needed to facilitate reimbursement Assists with the development of an annual market assessment, budget, and business plan and monitors expenditures and adherence to company policies through the implementation of controls Assists the Vice President with assessing business opportunities and provides information on costs that can be used in determining the feasibility of pursuing local managed care opportunities. When directed, gathers information about marketplace pay and bill rates Schedules staff meetings to communicate with employees, caregivers when appropriate, regarding the needs and concerns of patient/clients and their families, referral sources, clinical updates, policy and procedure changes, and payer sources and the potential for business that these customers represent Discusses operational issues to identify issues that may compromise optimal service to customers Employs marketing and promotional efforts within the community to support the achievement of new and existing programs Implements and maintains Quality Assurance Performance Improvement for the branch by participating in Quality Assessment and Improvement and CHAPs activities and assures participation of all appropriate staff Provides information that enables the collection and root-cause analysis of data to identify opportunities for improvement, develops/oversees the development and implementation of action plans that result in continuous quality improvement Oversees branch operations and makes adjustments where needed to increase the overall efficiency of the department Investigates complaints and incidents, and oversees and appropriate outcome/ resolution Submits reports on or before deadline dates Provides back up support and handles other functional role responsibilities, as required, to assure that operational needs are met In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000 primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000 older adults. Together, we're making health care work better for everyone. 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: Bachelor degree in health or business administration (four additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor's Degree) Registered Nurse with 6 years of experience in a clinical leadership / management role Recent experience in acute care or home care (within last 2 years) Working knowledge of governmental home health agency regulations, Medicare (Medicaid, as required), regulations and company policies and procedures Solid organizational, communication, interpersonal skills and reliable transportation This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease Preferred Qualifications: Experience in a community health or home health setting Demonstrated decision-making skills and strong judgment Bilingual speaking (English/Spanish) Physical and Mental Requirements: Ability to lift up to fifty (50) pounds (must be able to lift and transfer patients from one location to another, if necessary Ability to push/pull heavy objects using up to fifty (50) pounds of force Ability to sit for extended periods of time Ability to stand for extended period of time Ability to use fine motor skills to operate office equipment and/or machinery Ability to properly drive and operate a personal/company vehicle Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex situations 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 (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all 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 origin, 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.

  • Medina Lake, TX

  • no content

RN Enterprise Clinical Consultant Texas

WellMed, part of the Optum family of businesses, is seeking a Enterprise Clinical Consultant to join our team in Texas. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Enterprise Clinical Consultant is responsible for the management and supervision of all Homecare Dimensions Clinical Programs. They will implement and maintain performance improvement activities and maintains regulatory standards for the clinical programs across the branches. This Manager indirectly supervises all members of the branch staff and performs all functions in professional and ethical manner and collaborates with other members of the health care team to ensure quality patient care. The Enterprise Clinical Consultant will assure consistent, appropriate, and cost effective care by actively managing patient / client needs, payer's expectations, company policy compliance, and agency financial objectives. They will maintain accountability for achieving financial targets / profitability for the operation by empowering and challenging people, recruiting and training the best people, delivering quality in everything they do, providing the right incentives, providing the resources people need, and creating an environment that enables people to be successful. Primary Responsibilities: Directs the daily operations of Clinical Programs/ Operations to ensure the provision of safe, quality, cost-effective care to patients that contributes to the financial success of the branch Regularly evaluates the services and care provided by the branch to ensure compliance with regulatory requirements, company policies and procedures and sound business practices Directs the recruitment, hiring, and development of sufficient clinical and non-clinical staff to ensure the delivery of safe and consistent quality care to all patient/clients 24/ 7 Assures that clinical caregivers have demonstrated the ability to perform accurate and complete assessments, communicate with physicians, plan for service delivery, plan for discharge, and make excellent professional decisions Directs or delegates the assignment of staff, monitoring of daily and weekly schedules, and the matching of caregiver qualifications to patient/client needs, Manage quality through patient/client care appraisals and employee supervision Directs and participates in care coordination activities that effectively coordinate communication regarding patient/client problems, needs, psychosocial and spiritual concerns, and implementation of an individualized, interrelated plan of care Manages documentation to ensure that the patient/client's clinical record meets legal and regulatory requirements, facilitates care, enhances the continuity of care, helps coordinate treatment and evaluation of the patient/client, and establishes medical necessity so payers will reimburse for the services that are provided Develops and maintains a working knowledge of all services and resources available within the company and the community. Directs staff to meet patient/client needs through the identification and use of all available resources Responsible for interfacing with intake to assure that patient/client's are not admitted for clinical service (case accepted) until they have received an assessment visit and a determination has been made that they are appropriate for home care Responsible for annual evaluations of staff according to company policy and procedures and federal/state regulations Directs ongoing skill evaluations to assure that the staff's abilities are consistent with the needs of individual patient/clients and the marketplace Supervises clinical and operational processes by managing staff and ensuring flow of information and documentation from inquiry through discharge of all patient/clients Provides support and documentation needed to facilitate reimbursement Assists with the development of an annual market assessment, budget, and business plan and monitors expenditures and adherence to company policies through the implementation of controls Assists the Vice President with assessing business opportunities and provides information on costs that can be used in determining the feasibility of pursuing local managed care opportunities. When directed, gathers information about marketplace pay and bill rates Schedules staff meetings to communicate with employees, caregivers when appropriate, regarding the needs and concerns of patient/clients and their families, referral sources, clinical updates, policy and procedure changes, and payer sources and the potential for business that these customers represent Discusses operational issues to identify issues that may compromise optimal service to customers Employs marketing and promotional efforts within the community to support the achievement of new and existing programs Implements and maintains Quality Assurance Performance Improvement for the branch by participating in Quality Assessment and Improvement and CHAPs activities and assures participation of all appropriate staff Provides information that enables the collection and root-cause analysis of data to identify opportunities for improvement, develops/oversees the development and implementation of action plans that result in continuous quality improvement Oversees branch operations and makes adjustments where needed to increase the overall efficiency of the department Investigates complaints and incidents, and oversees and appropriate outcome/ resolution Submits reports on or before deadline dates Provides back up support and handles other functional role responsibilities, as required, to assure that operational needs are met In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000 primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000 older adults. Together, we're making health care work better for everyone. 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: Bachelor degree in health or business administration (four additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor's Degree) Registered Nurse with 6 years of experience in a clinical leadership / management role Recent experience in acute care or home care (within last 2 years) Working knowledge of governmental home health agency regulations, Medicare (Medicaid, as required), regulations and company policies and procedures Solid organizational, communication, interpersonal skills and reliable transportation This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease Preferred Qualifications: Experience in a community health or home health setting Demonstrated decision-making skills and strong judgment Bilingual speaking (English/Spanish) Physical and Mental Requirements: Ability to lift up to fifty (50) pounds (must be able to lift and transfer patients from one location to another, if necessary Ability to push/pull heavy objects using up to fifty (50) pounds of force Ability to sit for extended periods of time Ability to stand for extended period of time Ability to use fine motor skills to operate office equipment and/or machinery Ability to properly drive and operate a personal/company vehicle Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex situations 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 (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all 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 origin, 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.

  • Comfort, TX

  • no content

RN Enterprise Clinical Consultant Texas

WellMed, part of the Optum family of businesses, is seeking a Enterprise Clinical Consultant to join our team in Texas. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Enterprise Clinical Consultant is responsible for the management and supervision of all Homecare Dimensions Clinical Programs. They will implement and maintain performance improvement activities and maintains regulatory standards for the clinical programs across the branches. This Manager indirectly supervises all members of the branch staff and performs all functions in professional and ethical manner and collaborates with other members of the health care team to ensure quality patient care. The Enterprise Clinical Consultant will assure consistent, appropriate, and cost effective care by actively managing patient / client needs, payer's expectations, company policy compliance, and agency financial objectives. They will maintain accountability for achieving financial targets / profitability for the operation by empowering and challenging people, recruiting and training the best people, delivering quality in everything they do, providing the right incentives, providing the resources people need, and creating an environment that enables people to be successful. Primary Responsibilities: Directs the daily operations of Clinical Programs/ Operations to ensure the provision of safe, quality, cost-effective care to patients that contributes to the financial success of the branch Regularly evaluates the services and care provided by the branch to ensure compliance with regulatory requirements, company policies and procedures and sound business practices Directs the recruitment, hiring, and development of sufficient clinical and non-clinical staff to ensure the delivery of safe and consistent quality care to all patient/clients 24/ 7 Assures that clinical caregivers have demonstrated the ability to perform accurate and complete assessments, communicate with physicians, plan for service delivery, plan for discharge, and make excellent professional decisions Directs or delegates the assignment of staff, monitoring of daily and weekly schedules, and the matching of caregiver qualifications to patient/client needs, Manage quality through patient/client care appraisals and employee supervision Directs and participates in care coordination activities that effectively coordinate communication regarding patient/client problems, needs, psychosocial and spiritual concerns, and implementation of an individualized, interrelated plan of care Manages documentation to ensure that the patient/client's clinical record meets legal and regulatory requirements, facilitates care, enhances the continuity of care, helps coordinate treatment and evaluation of the patient/client, and establishes medical necessity so payers will reimburse for the services that are provided Develops and maintains a working knowledge of all services and resources available within the company and the community. Directs staff to meet patient/client needs through the identification and use of all available resources Responsible for interfacing with intake to assure that patient/client's are not admitted for clinical service (case accepted) until they have received an assessment visit and a determination has been made that they are appropriate for home care Responsible for annual evaluations of staff according to company policy and procedures and federal/state regulations Directs ongoing skill evaluations to assure that the staff's abilities are consistent with the needs of individual patient/clients and the marketplace Supervises clinical and operational processes by managing staff and ensuring flow of information and documentation from inquiry through discharge of all patient/clients Provides support and documentation needed to facilitate reimbursement Assists with the development of an annual market assessment, budget, and business plan and monitors expenditures and adherence to company policies through the implementation of controls Assists the Vice President with assessing business opportunities and provides information on costs that can be used in determining the feasibility of pursuing local managed care opportunities. When directed, gathers information about marketplace pay and bill rates Schedules staff meetings to communicate with employees, caregivers when appropriate, regarding the needs and concerns of patient/clients and their families, referral sources, clinical updates, policy and procedure changes, and payer sources and the potential for business that these customers represent Discusses operational issues to identify issues that may compromise optimal service to customers Employs marketing and promotional efforts within the community to support the achievement of new and existing programs Implements and maintains Quality Assurance Performance Improvement for the branch by participating in Quality Assessment and Improvement and CHAPs activities and assures participation of all appropriate staff Provides information that enables the collection and root-cause analysis of data to identify opportunities for improvement, develops/oversees the development and implementation of action plans that result in continuous quality improvement Oversees branch operations and makes adjustments where needed to increase the overall efficiency of the department Investigates complaints and incidents, and oversees and appropriate outcome/ resolution Submits reports on or before deadline dates Provides back up support and handles other functional role responsibilities, as required, to assure that operational needs are met In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000 primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000 older adults. Together, we're making health care work better for everyone. 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: Bachelor degree in health or business administration (four additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor's Degree) Registered Nurse with 6 years of experience in a clinical leadership / management role Recent experience in acute care or home care (within last 2 years) Working knowledge of governmental home health agency regulations, Medicare (Medicaid, as required), regulations and company policies and procedures Solid organizational, communication, interpersonal skills and reliable transportation This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease Preferred Qualifications: Experience in a community health or home health setting Demonstrated decision-making skills and strong judgment Bilingual speaking (English/Spanish) Physical and Mental Requirements: Ability to lift up to fifty (50) pounds (must be able to lift and transfer patients from one location to another, if necessary Ability to push/pull heavy objects using up to fifty (50) pounds of force Ability to sit for extended periods of time Ability to stand for extended period of time Ability to use fine motor skills to operate office equipment and/or machinery Ability to properly drive and operate a personal/company vehicle Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex situations 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 (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all 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 origin, 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.

  • Universal City, TX

  • no content

RN Enterprise Clinical Consultant Texas

WellMed, part of the Optum family of businesses, is seeking a Enterprise Clinical Consultant to join our team in Texas. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Enterprise Clinical Consultant is responsible for the management and supervision of all Homecare Dimensions Clinical Programs. They will implement and maintain performance improvement activities and maintains regulatory standards for the clinical programs across the branches. This Manager indirectly supervises all members of the branch staff and performs all functions in professional and ethical manner and collaborates with other members of the health care team to ensure quality patient care. The Enterprise Clinical Consultant will assure consistent, appropriate, and cost effective care by actively managing patient / client needs, payer's expectations, company policy compliance, and agency financial objectives. They will maintain accountability for achieving financial targets / profitability for the operation by empowering and challenging people, recruiting and training the best people, delivering quality in everything they do, providing the right incentives, providing the resources people need, and creating an environment that enables people to be successful. Primary Responsibilities: Directs the daily operations of Clinical Programs/ Operations to ensure the provision of safe, quality, cost-effective care to patients that contributes to the financial success of the branch Regularly evaluates the services and care provided by the branch to ensure compliance with regulatory requirements, company policies and procedures and sound business practices Directs the recruitment, hiring, and development of sufficient clinical and non-clinical staff to ensure the delivery of safe and consistent quality care to all patient/clients 24/ 7 Assures that clinical caregivers have demonstrated the ability to perform accurate and complete assessments, communicate with physicians, plan for service delivery, plan for discharge, and make excellent professional decisions Directs or delegates the assignment of staff, monitoring of daily and weekly schedules, and the matching of caregiver qualifications to patient/client needs, Manage quality through patient/client care appraisals and employee supervision Directs and participates in care coordination activities that effectively coordinate communication regarding patient/client problems, needs, psychosocial and spiritual concerns, and implementation of an individualized, interrelated plan of care Manages documentation to ensure that the patient/client's clinical record meets legal and regulatory requirements, facilitates care, enhances the continuity of care, helps coordinate treatment and evaluation of the patient/client, and establishes medical necessity so payers will reimburse for the services that are provided Develops and maintains a working knowledge of all services and resources available within the company and the community. Directs staff to meet patient/client needs through the identification and use of all available resources Responsible for interfacing with intake to assure that patient/client's are not admitted for clinical service (case accepted) until they have received an assessment visit and a determination has been made that they are appropriate for home care Responsible for annual evaluations of staff according to company policy and procedures and federal/state regulations Directs ongoing skill evaluations to assure that the staff's abilities are consistent with the needs of individual patient/clients and the marketplace Supervises clinical and operational processes by managing staff and ensuring flow of information and documentation from inquiry through discharge of all patient/clients Provides support and documentation needed to facilitate reimbursement Assists with the development of an annual market assessment, budget, and business plan and monitors expenditures and adherence to company policies through the implementation of controls Assists the Vice President with assessing business opportunities and provides information on costs that can be used in determining the feasibility of pursuing local managed care opportunities. When directed, gathers information about marketplace pay and bill rates Schedules staff meetings to communicate with employees, caregivers when appropriate, regarding the needs and concerns of patient/clients and their families, referral sources, clinical updates, policy and procedure changes, and payer sources and the potential for business that these customers represent Discusses operational issues to identify issues that may compromise optimal service to customers Employs marketing and promotional efforts within the community to support the achievement of new and existing programs Implements and maintains Quality Assurance Performance Improvement for the branch by participating in Quality Assessment and Improvement and CHAPs activities and assures participation of all appropriate staff Provides information that enables the collection and root-cause analysis of data to identify opportunities for improvement, develops/oversees the development and implementation of action plans that result in continuous quality improvement Oversees branch operations and makes adjustments where needed to increase the overall efficiency of the department Investigates complaints and incidents, and oversees and appropriate outcome/ resolution Submits reports on or before deadline dates Provides back up support and handles other functional role responsibilities, as required, to assure that operational needs are met In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000 primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000 older adults. Together, we're making health care work better for everyone. 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: Bachelor degree in health or business administration (four additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor's Degree) Registered Nurse with 6 years of experience in a clinical leadership / management role Recent experience in acute care or home care (within last 2 years) Working knowledge of governmental home health agency regulations, Medicare (Medicaid, as required), regulations and company policies and procedures Solid organizational, communication, interpersonal skills and reliable transportation This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease Preferred Qualifications: Experience in a community health or home health setting Demonstrated decision-making skills and strong judgment Bilingual speaking (English/Spanish) Physical and Mental Requirements: Ability to lift up to fifty (50) pounds (must be able to lift and transfer patients from one location to another, if necessary Ability to push/pull heavy objects using up to fifty (50) pounds of force Ability to sit for extended periods of time Ability to stand for extended period of time Ability to use fine motor skills to operate office equipment and/or machinery Ability to properly drive and operate a personal/company vehicle Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex situations 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 (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all 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 origin, 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.

  • Somerset, TX

  • no content