The quality of care we provide our patients doesn't change no matter how it is delivered. Joining Unitedhealthcare as a Call Center Registered Nurse can be your opportunity to offer a higher level of care to our members. While your work will take place over the phone, you'll have a direct impact on the lives of our members, recommending an appropriate level of clinical care and connecting them with the resources they need to make informed health decisions. You'll act as a compass for our members, guiding them through a complex medical environment as you identify appropriate providers and services, act as a health coach and provide referrals in order to optimize health outcomes. What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. Purpose of Job: Role is responsible for providing clinical review and triage of referrals within the RS services across Optum, utilizing approved medical protocols per policy, and recommending an appropriate level of clinical care based on clinical judgment and protocols. To act as an expert clinical resource for the RS teams supporting the Lead Nurse and Head of Operations in clinical training, complaint resolution and quality improvement. Job Scope and GuidelinesUses pertinent data and facts to identify and solve a range of problems within area of expertiseInvestigates non-standard requests and problems, with some assistance from othersWorks exclusively within a specific knowledge areaPrioritizes and organizes own work to meet deadlinesProvides explanations and information to others on topics within area of expertisePrimary Responsibilities:Clinical:Clinically triage referrals in line with agreed specialties ensuring that they meet the referral criteria for onward bookingAnalyzes and investigatesProvides explanations and interpretations within area of expertiseWhere a referral does not meet the criteria or there is clinical information missing the referral should be returned to the referrer with clear advice and guidance as to the reasons - this will then go through to a GP to provide secondary triage and either confirm or disagree with the original triage decisionWhere a referral does meet the criteria provide the referrer with advice and feedback on their referral if appropriateTo keep clinical quality at the forefront of all decision making within the RFSTriage all referrals within productivity timelinesProvide high quality and comprehensive feedback to referrers on the quality of their referralsUtilise best practice guidance for all referrals processed within the RFSThrough the triage process highlight any concerns around quality of referrals from specific GPs or practicesLiaise with GP Triager colleagues on difficult or challenging referralsTo utilise the RFS systems accurately and fully for the purposes of comprehensive data collectionSupport the development of clinical protocols and guidelines for the RFS servicesQuality audit clinical triage and work with colleagues to demonstrate the value of clinical triage Provide coaching and support on clinical terminology and referral pathways to RFS team Leadership:Provide the admin teams with clinical expertise, knowledge and supportParticipate and support the GP and consultant Triage meetingsContribute to the development of improved ways of working within the RSMaintain a high level of confidentiality in all aspects of work including participant records and conversations Maintain accurate information systems of records and activitiesAdhere to organisational policies and procedures including clinical governance and patient confidentialityCommunication:Communicate professionally and effectively with participants and all other stakeholders, providing accurate, relevant information as requiredCommunicate across language and cultural barriers within groups in partnership with the available agenciesProvide excellent customer service Manage all calls in a customer focused and professional mannerProfessional & Educational Development:Provide a high standard of care at all times in accordance with the Code of Professional Conduct (NMC 2015) and any other company policy or procedural requirementsDevelop a Personal Development Plan that both fulfills the requirements of the post and allows for personal and professional developmentUndertake refresher training to maintain clinical triage skillsParticipate in any mandatory training for the role and undertake any additional necessary training to undertake the role competently and efficientlyEngage in clinical supervision and self-evaluation using this as a method to improve care and practiceEnsure patient confidentiality at all times in accordance with the Code of Professional Conduct (NMC 2015) and other service and corporate requirementsPositively engage in the Maximising Accountability and Performance (MAP) processThe role whilst based within the RFS at West London there will be travel to Contract locations and opportunity to work remotely on occasions.
Required Qualifications:Registered General Nurse - current NMC registrationDemonstrable experience of working as an autonomous Nurse Practitioner within a triaging environmentExperience in providing first contact / triage servicesExperience of providing Long Term Conditions managementIntermediate IT competence, including use of MS OfficeGood understanding of the current Primary Care agendaUnderstanding of service user confidentialityPreferred Qualifications:Degree Level Nurse PractitionerMasters Level DegreeExtended & Supplementary PrescribingTeaching & Assessing - C&G 7303 or equivalentGood knowledge of the work of General Practice Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Job Keywords: Triage Nurse (Primary Care), Ealing, UK, United Kingdom
Internal Number: 715680
About UnitedHealth Group
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.