Senior Clinical Administrator RN

3 weeks ago


Milwaukee, Wisconsin, United States UnitedHealthcare Full time

Job Summary:

We are seeking a highly skilled Registered Nurse to join our team as a Clinical Health Advocate RN. In this role, you will play a critical part in promoting wellness and good health habits in our employee population.

Key Responsibilities:

  • Promote wellness and good health habits in the employee population in all activities and interactions.
  • Identify high-risk and emerging risk members to engage with them for stabilization through ongoing one-on-one interactions.
  • Collaborate with the QuadMed Clinics on member-facing communication and activities.
  • Coordinate the delivery of healthcare for high-risk and emerging risk members by ensuring engagement with specialists, assisting with timely initial and follow-up appointments, medication management, and compliance to treatment plans.
  • Identify and educate members utilizing non-QuadMed Urgent Care services to promote steerage back into the QuadMed Clinics for future Acute Care and encourage adoption of a Primary Care Provider.
  • Assist in steerage to Premium Designated Providers for Care as needed when not available at QuadMed.
  • Refer to and partner with the Case Management and UMR team as needed for Member engagement and participation in UMR programs.
  • Partner with Quad/QuadMed team to facilitate engagement in appropriate Quad/QuadMed internal Health Programs.

Requirements:

  • Current and unrestricted compact Wisconsin RN license.
  • 2+ years of acute nursing experience as an RN.
  • Basic computer proficiency (ie MS Word, Outlook).
  • Ability to obtain multi-state licensure as required.

Preferred Qualifications:

  • Case Management Certification (CCM).
  • 2+ years of managed care experience.
  • 2+ years of experience in employee wellness and/or health promotion.
  • Call center experience.
  • Clinical experience outside of the hospital setting.
  • Case management experience.
  • Experience in Oncology, Musculoskeletal, ER, and Discharge Planning.

Soft Skills:

  • Demonstrated excellent verbal and written communication skills.
  • Excellent customer service orientation.
  • Proven team player and team building skills.
  • Ability and flexibility to assume responsibilities and tasks in a constantly changing work environment.

About UnitedHealthcare:

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities, and removing barriers to quality care. We believe everyone deserves the opportunity to live their healthiest life.

We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.

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.



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