Senior Inpatient Services Case Manager

7 days ago


Irving, Texas, United States UnitedHealth Group Inc Full time
Job Summary

We are seeking an experienced RN Case Manager to join our team in Texas. As a RN Case Manager, you will play a crucial role in coordinating care for members from admission through discharge.

About the Role:

  • Collaborate effectively with the Interdisciplinary Care Team (ICT) to establish individualized transition plans for members
  • Serve as a clinical liaison with hospitals, clinical and administrative staff, and perform reviews for clinical authorizations using evidence-based criteria
  • Conduct onsite or telephonic clinical reviews at in-network and out-of-network facilities, documenting medical necessity and appropriate level of care
  • Interact and communicate with facility staff, members, and their families to assess discharge needs, formulate discharge plans, and provide health plan benefit information

Requirements:

  • Bachelor's degree in Nursing and/or Associate's degree in Nursing combined with 4+ years of experience
  • Current, unrestricted RN license required, specific to the state of employment
  • Case Management Certification (CCM) or ability to obtain CCM within 12 months after the first year of employment
  • 4+ years of diverse clinical experience in caring for acutely ill patients with multiple disease conditions

Benefits:

  • A competitive salary range of $80,000 - $110,000 per annum
  • Opportunity to work with a leading healthcare organization
  • Chance to develop your skills and expertise in case management

About Us:

We are part of UnitedHealth Group Inc., a global leader in healthcare services. Our company is committed to making healthcare better for everyone.



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