Telephonic RN Case Manager - Telecommute Opportunity

Company: UnitedHealth Group ( Learn More )

General Information
US-OH-Blue Ash
Not Specified
Not Specified
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Job Description For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

***Shift is Monday - Friday. Candidates must have an ability to work 11:30am-8:00pm***

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

  • Making referrals to outside sources

  • Coordinating services as needed (home health, DME, etc.)

  • Educating members on disease processes

  • Encouraging members to make healthy lifestyle changes

  • Documenting and tracking findings

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

  • Making "welcome home" calls to ensure that discharged member receive the necessary services and resources

  • Required Qualifications:

  • Current, unrestricted RN license in the state of residence

  • 3 years experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company

  • Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment

  • Ability to work 11:30am-8pm Monday-Friday

  • Willingness to obtain additional licensures as needed

  • Preferred Qualifications:

  • Bachelor's Degree

  • Minimum of 5 years clinical RN background

  • Bilingual (Fluent in English and Spanish)

  • A background in managed care

  • Case Management experience

  • Certified Case Manager (CCM)

  • Experience/exposure with discharge planning

  • Experience in utilization review, concurrent review and/or risk management

  • Strong organizational skills and multitasking abilities will be keys to success

  • Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do

    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.

    Job Keywords: Telephonic RN Case Manager, Lisle, Illinois, IL; Richardson, Texas, TX; St. Louis, Missouri, MO; Phoenix, Arizona, AZ; Atlanta, Georgia, GA; West Chester, Ohio, OH; Blue Ash

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