See more Collapse

Telephonic RN Case Manager

1 month ago

Irving TX United States UnitedHealth Group Inc Full time
Telephonic RN Case Manager - Remote in Dallas Texas

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. WellMed provides concierge - level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient's health. WellMed's proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optum division under the greater UnitedHealth Group umbrella. The Case Manager is a participant in the collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs. This process includes medical, social, developmental, behavioral, financial, and educational intervention with focus on quality and cost-effective outcomes. The RN Case Manager schedule is Monday - Friday, 8a - 5p, local time, no weekends, or holidays. If you are located Texas, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: * Engage and provide care management to commercial patient populations identified from the Health Plan, clinical meetings, outlier reports, plan specific insights, and predictive modeling * Complete Transition of Care follow up and assessment post discharge * Provide care management telephonically * Complete required assessments * Create a personalized care plan for each patient involved in care management to resolve barriers to care, close quality gaps in care, build additional education or contingency planning and engage with social support systems as appropriate * Regularly interact with health plan clinical programs and clinical personnel for care coordination * Complete all necessary care coordination and or assessment activities as outlined in the care plan * At least monthly or as needed, attend telephonic patient care conferences/meetings with the clinic or health plan on assigned patients involved in care management * Weekly and as needed, participate in internal JOC meetings for plan specific insights, best practices and intervention development * Follow NCQA Care Management, Person Centered Medical Home and Accountable Care Organization accreditation standards * Document all patient care activities into electronic database * Meet required Key Performance Indicators * Pass Quality Audit metrics * Coordinate and cooperate with other members of the care management team * Support team through onboarding and training of new hire members * Perform other duties as assigned 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: * Current, unrestricted RN license, specific to the state of employment including ability to obtain additional state licenses * 3+ years of experience in a hospital, acute care or direct care setting * Proficiency in Microsoft Office products including Access, Excel, Word, PowerPoint and Outlook * Ability to attend occasional staff meetings onsite at the DSW office * Access to highspeed internet and a distraction free workspace Preferred Qualifications: * Case Management Certification (CCM) * Managed care and/or care management experience * Experience in completion of assessment, care plans, care coordination and issue resolution * Electronic case management and medical record experience * Demonstrated skills in the areas of negotiation, communication (verbal and written), conflict, interdisciplinary collaboration, management, creative problem solving, and critical thinking. * Knowledge of healthcare reimbursement, Utilization Management, discharge planning, Disease Management * Intermediate knowledge of Commercial Plans, applicable state Department of Insurance regulations and health plans * Knowledge of NCQA standards in Primary Care Medical Home and Care Management, as well as Accountable Care Organization * Demonstrated ability to work remotely * Patient engagement experience including solid telephonic motivational interviewing skills * 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.

We have other current jobs related to this field that you can find below

  • Telephonic RN Case Manager

    1 month ago

    Irving, United States UnitedHealth Group Full time

    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. WellMed provides concierge - level medical care and service for seniors, delivered by physicians and clinic staff that...

  • Telephonic RN Case Manager

    1 month ago

    Irving, United States Optum Full time

    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. WellMed provides concierge - level medical care and service for seniors, delivered by physicians and clinic staff that...

  • Telephonic RN Case Manager

    1 month ago

    Irving, United States UnitedHealth Group Full time

    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. WellMed provides concierge - level medical care and service for seniors, delivered by physicians and clinic staff that...

  • Telephonic Case Manager RN Behavioral Health

    2 weeks ago

    Wausau, WI, United States UnitedHealth Group Full time

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

  • Telephonic Nurse Case Manager I

    3 days ago

    Wilmington, DE, United States Elevance Health Full time

    Telephonic Nurse Case Manager IDescription Telephonic Nurse Case Manager I Location: This is a virtual position. Prefer candidates reside within 50 miles of an Elevance Health Pulse Point location. Hours: Monday - Friday 8:00am - 4:30pm EST, with some evening availability. The Telephonic Nurse Case Manager I is responsible for performing care management...

  • Telephonic Nurse Case Manager ll

    1 month ago

    Denver, CO, United States Elevance Health Full time

    Telephonic Nurse Case Manager llDescription "Telephonic" Nurse Case Manager II Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location. Hours: Monday - Friday 9:00am to 5:30pm EST and 1 late evening 11:30am to 8:00pm EST. * This position will service members in different states; therefore...

  • Care Coach Connect RN Case Manager

    3 days ago

    Irving, TX, United States UnitedHealth Group Inc Full time

    Care Coach Connect RN Case Manager - Lubbock, TXFor 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 Care Coach Connect RN/Case Manager coordinates care and provides initial...

  • Registered Nurse

    1 week ago

    Farmington, NM, United States Professional Case Management Full time

    Professional Case Management,the leader in home healthcare in New Mexico,is now hiring RN Case Managers to provide in-home healthcare case management services to help those who have served our country! Come join our growing team! A few of our perks:Create your own schedule!$40/hr. (including 100% of Hourly Wage Paid for All Drive Time) Our RN-Case Managers...

  • Registered Nurse

    1 week ago

    Opelika, AL, United States Professional Case Management Full time

    Professional Case Management,the leader in home healthcare in Alabama,is now hiring RN Case Managers to provide in-home healthcare case management services to help those who have served our country! Come join our growing team! A few of our perks:Create your own schedule!$38/hr. (including 100% of Hourly Wage Paid for All Drive Time) Our RN-Case Managers...

  • Registered Nurse

    1 week ago

    Denver, CO, United States Professional Case Management Full time

    Professional Case Management,the leader in home healthcare in Colorado,is now hiring RN Case Managers to provide in-home healthcare case management services to help those who have served our country! Come join our growing team! A few of our perks:Create your own schedule!$42/hr. (including 100% of Hourly Wage Paid for All Drive Time) Our RN-Case Managers...

  • RN Case Manager

    2 days ago

    Irving, TX, United States HarmonyCares Full time

    RN Case ManagerOverview HarmonyCares is one of the nation's largest home-based primary care practices. HarmonyCares is a family of companies all dedicated to providing high-quality, coordinated health care in the home. This includes HarmonyCares, HarmonyCares Medical Group, HarmonyCares Home Health and HarmonyCares Hospice. Our Mission - To bring...

  • Registered Nurse

    4 weeks ago

    Barnwell, SC, United States Professional Case Management Full time

    Professional Case Management, the leader in home healthcare in South Carolina, is now hiring RN Case Managers to provide in-home healthcare case management services to help those who have served our country! Benefit from one-on-one client relationships and from the satisfaction of enhancing clients' health, quality of life and peace of mind. You will work...

  • Case Manager-RN

    2 weeks ago

    Redlands, CA, United States Loma Linda University Full time

    Job Summary: The RN-Case Manager is responsible for utilization management and inpatient care management in a telephonic and/or onsite care management position; performs reviews of inpatient and outpatient services to determine medical appropriateness following evaluation of medical guidelines and benefit determination; focuses on changing from...

  • Case Manager-RN

    4 weeks ago

    Redlands, CA, United States Loma Linda University Full time

    Job Summary: The RN-Case Manager is responsible for utilization management and inpatient care management in a telephonic and/or onsite care management position; performs reviews of inpatient and outpatient services to determine medical appropriateness following evaluation of medical guidelines and benefit determination; focuses on changing from...

  • RN Field Case Manager

    3 weeks ago

    Houston, TX, United States UnitedHealth Group Inc Full time

    RN Field Case ManagerFor 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 Care Coach Connect RN/Case Manager coordinates care and provides initial ongoing nursing assessment...

  • RN Field Case Manager

    4 days ago

    Houston, TX, United States UnitedHealth Group Inc Full time

    RN Field Case ManagerOpportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference...

  • RN Inpatient Case Manager Remote from West Texas

    1 month ago

    Lubbock, TX, United States UnitedHealth Group Inc Full time

    RN Inpatient Case Manager Remote from West TexasFor 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. Inpatient Services Case Manager performs telephonic clinical review of...

  • RN Case Manager, Inpatient Services

    1 month ago

    Dallas, TX, United States UnitedHealth Group Inc Full time

    RN Case Manager, Inpatient Services - Remote from North TexasFor 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 RN Case Manager II - Inpatient Services performs onsite...

  • RN Case Manager PHM Compact Lics

    2 months ago

    San Antonio, TX, United States UnitedHealth Group Inc Full time

    RN Case Manager PHM Compact LicsOpportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a...

  • RN Field Case Manager

    1 month ago

    Houston, TX, United States UnitedHealth Group Inc Full time

    RN Field Case ManagerFor 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 Care Coach Connect RN/Case Manager coordinates care and provides initial ongoing nursing assessment...