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Sr. Case Manager RN

2 months ago


Everett, United States UnitedHealth Group Full time

$7,500 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.

Position in this function is responsible for ensuring the continuity of care in the outpatient setting utilizing the appropriate resources and patient quality outcomes. Facilitates continuum of patients' care, with a command-center “virtual hospital” hybrid team, utilizing advanced nursing knowledge, experience, and skills.

If you live near Everett, WA you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • Provide care to patients remotely through video conferencing, phone calls and other forms of communication

  • Navigating patients and families across the continuum of hospital at home care

  • Providing protocol driven assessment, care coordination and interventions as appropriate informed by, an external vendor

  • Facilitating admissions to hospital at home care, identify and escalate potential health concerns to appropriate healthcare/brick and mortar Providers promptly

  • Documenting patient-care activities in the patient’s electronic medical record

  • Make outbound calls and receive inbound calls to assess members’ current health status

  • Identify gaps or barriers in treatment plans

  • Provide patient education to assist with self-management

  • Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction

  • Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels

Job Scope And Guidelines:

  • Flex position between Call Us First, a 24-hour dedicated line serving Medicare patient population and Optum Acute Care at Home, providing virtual hospital level care (while patients stay home)

  • Utilizes clinical expertise and approved protocols to provide health advice to consumers with clinical questions and makes referrals for health services as appropriate via telephone

  • Able to document calls in applicable system in a timely manner and exhibits a willingness to master new work routines and methods

  • Documents all inquiries according to department standards for legal/statistical purposes

  • Excellent written and verbal communication skills

  • Able to problem solve issues independently as well as work with teams collaboratively situations require assessment, decision-making within the framework of established protocols, excellent listening and communication skills, knowledge of computers, critical thinking skills and the nursing process

  • Serves as a key resource on complex and/or critical issues

  • Comfort in an ambiguous environment

  • Provides explanations and information to others on the most complex issues

Functional Competencies:

  • Complete assessments and utilize nursing process to deliver hospital level care in a virtual setting

  • Utilizes clinical expertise and approved protocols to provide health advice to consumers with clinical questions as appropriate via telephone

  • Leverage technology including on-line resources (e.g., Internet sites, internal websites) or other approved decision support tools to research information, understand/define information provided and document information

  • Consult with others (e.g., interdisciplinary team members) to review clinical assessment and obtain input as necessary

  • Identify appropriate interventions and resources to meet gaps (e.g., psychosocial, transportation, long-term care)

  • Consult with patient and family/caregiver to create a shared care plan

  • Reassess plan of care at appropriate intervals based on initial objectives, significant change of condition, or achievement of goals

  • Utilize resources to enhance professional practice and development based on learning gaps or new information

  • Adaptability and flexibility in response to changing workloads and priorities

  • Time management and organizational skills: effectively managing multiple patients, appointments, and tasks remotely

  • Solid emotional intelligence and resilience are essential to navigate emotionally challenging situations and deal with ambiguity

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:

  • Graduation from an accredited school of nursing

  • Unrestricted Washington State RN license

  • 3+ years of experience working inpatient within the last 5 years. Medical/Surgical, Medicine with IV, Home Based Care, and/or ER experience

  • MS Office suite (Word, Excel, PowerPoint, Teams), video conferencing platforms (Zoom), EMR systems, and other virtual healthcare tools is crucial

Preferred Qualifications:

  • Bachelor of Science degree in Nursing

  • Undergraduate degree or equivalent experience

  • Specialty fields such as acute care, oncology, or geriatrics

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

Washington Residents Only: The hourly range for this role is $33.75 to $66.25 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.