Telephonic RN Case Manager Specialist
2 weeks ago
UnitedHealth Group Inc is a global organization that delivers care and technology to help millions of people live healthier lives. The company is committed to mitigating its impact on the environment and enabling equitable care that addresses health disparities and improves health outcomes.
Salary InformationThe estimated salary for this position is $65,000 - $122,000 per annum. This compensation package includes comprehensive benefits, incentive programs, equity stock purchase, and 401k contribution.
Job DescriptionCompany Overview: UnitedHealth Group Inc is a global organization that delivers care and technology to help millions of people live healthier lives. The company's mission is to make healthcare work better for everyone.
Key Responsibilities: As an RN Telephonic Nurse Case Manager, you will be responsible for clinical operations and medical management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring, and evaluating. You will also provide health education, coaching, and treatment decision support for members.
Primary Responsibilities:
- Making outbound calls to assess members' current health status
- Identifying gaps or barriers in treatment plans
- Providing patient education to assist with self-management
- Interacting with Medical Directors on challenging cases
- Coordinating care for members and services as needed (home health, DME, etc.)
- Educating members on disease processes
- Encouraging members to make healthy lifestyle changes
- Utilizing Milliman criteria to determine if patients are in the correct hospital setting
- Making 'welcome home' calls to ensure that discharged members receive the necessary services and resources
- Documenting and tracking findings
Requirements:
- Active, unrestricted RN license in a compact state
- 3+ years of clinical experience (any setting)
- Computer proficiency utilizing MS Office (Word, Excel, PowerPoint, and Outlook), including the ability to type and talk at the same time while navigating a Windows environment
- Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or can leverage existing high-speed internet service
- Access to dedicated work space from home for in-home office setup
Preferred Qualifications:
- BSN
- Certified Case Manager (CCM)
- ICU, Cardiology, or Critical Care experience
- Telephonic case management experience
- Experience with discharge planning
- Experience in a remote position
- Bilingual - English/Spanish
- Solid working knowledge chronic medical diagnoses (CHF, COPD, diabetes, etc.)
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