Telephonic Nurse Case Manager RN

3 months ago

Buffalo, 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, 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 Telephonic Nurse Case Manager, 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

The schedule is Monday - Friday: 3 days/week 8 am - 5 pm, 2 days/week 11 am - 8 pm. Working until 8pm two nights/week is required.

Selected candidates must be able to start working on site in our office located at 600 Airborne Pkwy, Cheektowaga, NY. Opportunities for hybrid arrangements may be given over time based on business needs and if all job goals are being met.

Primary Responsibilities:

  • Make outbound calls to assess members' current health status

  • Identify gaps or barriers in treatment plans

  • Provide patient education to assist with self-management

  • Interact with Medical Directors on challenging cases

  • Coordinate care for members

  • Make referrals to outside sources

  • Coordinate services as needed (i.e., home health, DME, etc.)

  • Educate members on disease processes

  • Encourage members to make healthy lifestyle changes

  • Document and track findings

  • Utilize Milliman criteria to determine if patients are in the correct hospital setting

  • Make ‘welcome home’ calls to ensure that discharged members receive the necessary services and resources

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:

  • Active, unrestricted RN license in the State of New York

  • Multiple state licensure (in addition to Compact License if applicable) OR the ability to obtain multiple state nursing licenses

  • 3+ years of RN experience in a hospital setting, acute care, direct care, or as a Case Manager at an insurance company

  • Computer proficiency including navigating a Windows environment; using MS Outlook; creating, editing, saving, and sending documents in MS Word; talking and typing at the same time; and using multiple applications simultaneously

  • Ability to work Monday - Friday: 3 days/week 8 am - 5 pm and 2 days/week 11 am - 8 pm

  • Ability to work onsite in our Cheektowaga, NY office for the first 6-12 months

  • Access to install secure, high-speed internet and a dedicated workspace at home

Preferred Qualifications:

  • Bachelor's degree

  • Certified Case Manager (CCM)

  • Home health experience

  • Managed care experience

  • Case management experience

  • Experience with/exposure to discharge planning

New York Residents Only: The salary range for this role is $58,300 to $114,300 annually. 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.

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