Healthcare Professional

3 days ago


Fort Worth, Texas, United States UnitedHealth Group Inc Full time

At UnitedHealth Group, we are committed to helping people live healthier lives and making the health system work better for everyone. As a Case Manager RN, you will play a vital role in driving Referral Management and appropriate sites of service, facilitating Care Transitions and Care for High-Risk patients.

This position integrates pharmacy management, care coordination, utilization management, and care transition management. If you reside in TX, AZ, or CO, you'll enjoy the flexibility to telecommute as you take on some tough challenges.

The salary range for this role is $58,300 to $114,300 per year, depending on experience. Our comprehensive benefits package includes paid time off, medical plan options, dental, vision, life & AD&D insurance, 401(k) savings plan, education reimbursement, employee discounts, and more.

As a Case Manager RN, your primary responsibilities will include:

  • Working with a Care Team of a Clinical Pharmacist and Clinical Administrative Coordinator to support patient and provider engagement for Care Transitions Management, Care Coordination, and Medication Therapy Management
  • Facilitating inpatient discharge information to Care Team and Primary Care Offices using appropriate technology tools
  • Consulting with patients who have had an inpatient discharge; facilitating scheduling transitions of care follow-up appointments with PCP and/or specialists
  • Consulting with patients who have had an ED discharge; facilitating scheduling follow-up appointments as needed; reviewing post-discharge information with patients and educating on alternative sites of care
  • Engaging high-risk patients telephonically to schedule appointments with Clinical Pharmacist for Comprehensive Medication Reviews
  • Preparing patient cases in workflow management platform for Clinical Pharmacist patient engagement
  • Consulting with patients identified as needing a specialist referral to recommend high-quality, lower-cost specialists
  • Supporting high-risk patients by scheduling PCP and/or specialist appointments on their behalf
  • Providing benefit information and resources to patients upon request
  • Communicating with provider offices to problem-solve patient issues and/or facilitate communication between practice staff and Care Team
  • Notifying PCP and Care Team Clinical Pharmacist of relevant clinical information gathered during calls to patient that may affect the patient's disease state or medication regimen
  • Developing strong relationships with provider offices participating with Practice Extend program by communicating program goals, patient needs, and value-based opportunities
  • Facilitating and/or leading meetings with provider offices for initial onboarding meetings and ongoing collaboration meetings

To be successful in this role, you will need:

  • Bachelor's Degree (or higher)
  • Unrestricted, compact licensure as a Registered Nurse for applicable states within our program
  • 4+ years of Case Management and/or Care Coordination experience
  • 3+ years of experience in managing populations with complex medical or behavioral needs
  • Intermediate level of proficiency with Microsoft Office, Outlook, and Teams applications and ability to quickly learn clinical applications and multi-system management
  • Ability to travel up to 10% to local office(s) to accommodate business needs

We are committed to creating a diverse and inclusive environment where everyone has the opportunity to thrive. If you're passionate about delivering exceptional patient care and improving health outcomes, join us at UnitedHealth Group Inc.



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