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Telephonic Case Manager

3 months ago

Newark, 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.

The Telephonic RN Case Manager will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting member’s medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care.

Primary Responsibilities:

  • Engage members telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs

  • Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines

  • Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan

  • Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health

  • Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission

  • Advocate for members and families as needed to ensure the member’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:

  • Current, unrestricted independent licensure as a Registered Nurse in New York

  • New York state issued ID or ability to obtain one prior to hire

  • 4+ years of clinical experience

  • 1+ years of experience with MS Office, including Word, Excel, and Outlook

Preferred Qualifications:

  • BSN, Master's degree or higher in clinical field

  • CCM certification

  • 1+ years of community case management experience coordinating care for individuals with complex needs

  • Experience working in team-based care

  • UAS Assessment experience

  • Background in Managed Care

  • Telephonic case management experience

Physical Requirement:

  • Ability to remain stationary for long periods of time to complete computer or tablet work duties

New Jersey or New York Residents Only: The hourly range for this role is $28.03 to $54.95 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: 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.