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RN Case Manager, Remote in KY

4 weeks ago

Paducah, United States UnitedHealth Group Full time

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

You push yourself to reach higher and go further. Because for you, it’s all about ensuring a positive outcome for patients. In this role, you’ll work in the field and coordinate the long-term care needs for patients in the local community. And at every turn, you’ll have the support of an elite and dynamic team. Join UnitedHealth Group and our family of businesses and you will use your diverse knowledge and experience to make health care work better for our patients.

In this Care Coordinator - Community Based role, you will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs.

If you are located in or near the Louisville, Lexington, Owensboro, Bowling Green, Pikeville, and Paducah areas of KY, you will have the flexibility to work remotely* as you take on some tough challenges.

You’ll need to be flexible, adaptable and, above all, patient in all types of situations.

Primary Responsibilities:

  • Assess, plan and implement care management interventions that are individualized for each patient and directed toward the most appropriate, least restrictive level of care

  • Identify and initiate referrals for both healthcare and community-based services; including but not limited to financial, psychosocial, community and state supportive services

  • Develop and implement care plan interventions throughout the continuum of care as a single point of contact

  • Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members

  • Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team

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:

  • Active, unrestricted Registered Nurse KY license

  • 4+ years of clinical experience working within the community health setting OR in a health care role

  • 2+ years of experience providing community-based care management to members receiving long-term care, personal care services, private duty nursing, or home health

  • Solid computer skills including EHR documentation, MS Office, etc.

  • Available to attend weekly, monthly and quarterly on site meetings

  • Access to reliable transportation and the ability to travel up to 25% within assigned region to visit Medicaid members in their homes and / or other settings, including community centers, hospitals or providers' offices

  • Live in Kentucky

Preferred Qualifications:

  • BSN or health care related degree

  • CCM

  • Experience in managing populations with complex medical or behavioral needs

  • Experience working with Home Care Based Services

  • Experience working with patients/members in community and home-based settings

  • Experience with discharge planning

  • Experience with utilization review, concurrent review and/or risk management

  • Experience with arranging community resources

  • Case Management experience

  • Prior field-based work experience

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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