Senior RN Complex Case Manager
2 months ago
$10,000 Sign-On Bonus for External Candidates
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
The Senior Case Manager will identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for members.
Primary Responsibilities:
* Applies motivational interviewing in identifying impact on member engagement and setting goals
* Member education, medication reconciliation and benefit management
* Ensures follow through with the Care Navigation Team; timely appointments and referrals to programs, health plan and community
* Facilitate patient/family and provider communications as indicated and advocate for patient/family with healthcare team as needed
* Ensures coordinated services delivered and available programs are accessed
* Communicate with stakeholders, appropriate health care related information to ensure timely coordination care and services for members currently receiving inpatient care
* Utilizes approved clinical criteria to asses and determine appropriate level of care for members currently receiving inpatient care
* Identified point of contact for managing transitions of care
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.
Years of post-high school education can be substituted/is equivalent to years of experience
Required Qualifications:
* Current, unrestricted NV RN license
* 3+ years of direct patient care nursing with a focus on discharge planning or case management
* Proven knowledge of UM and plan benefit designs
* Proven knowledge of Utilization review and MCG
* Competent with MS Office and other practice management systems or possess the ability to continue to learn new things
* Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
Preferred Qualifications:
* CCM certification
* Solid clinical knowledge and capacity for continued learning
* Proficient in critical thinking skills of RN Case manager
* Proven ability to organize and prioritize tasks for self and patients
* Proven solid verbal and written communication skills
* Ability to perform case management activities
Nevada Residents Only: The salary range for Nevada residents is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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