Telephonic RN Case Manager

1 week ago

Richardson, United States UnitedHealth Group Full time

$5,000 Sign-on Bonus for External Candidates

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, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today

Positions in this function require various nurse licensure and certification based on role and grade level. These roles 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. Includes Health Coach, Health Educator, and Health Advocate roles that require an RN. *Employees in jobs labeled with 'SCA' must support a government Service Contract Act (SCA) agreement. Generally work is self-directed and not prescribed.

Work schedule is Monday-Friday, business hours for three days then 11am - 8pm for two days a week.

Primary Responsibilities:

  • Make outbound calls and receive inbound calls to assess members' current health status
  • Make referrals to outside sources
  • 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
  • Works with less structured, more complex issues
  • Serves as a resource to others

This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes

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:

  • Undergraduate degree or equivalent experience
  • Current, unrestricted RN license in the state of employment
  • 3+ years of experience in a hospital, acute care or direct care setting
  • Ability to support a Hybrid work schedule, including consumer centric hours (11a - 8p CST) two days a week
  • Ability to type and have the ability to navigate a Windows based environment

Preferred Qualifications:

  • BSN
  • Certified Case Manager (CCM)
  • Case management experience
  • Experience or exposure to discharge planning
  • Experience in discharge planning or utilization review
  • Experience in a telephonic role
  • Experience in a leadership, account management or client facing role
  • Background in managed care


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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