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Care Manager RN - Per Diem - National Remote
UnitedHealth Group - Bangor, ME
posted about 1 month ago
About the position
The Care Manager RN - Per Diem role at UnitedHealth Group involves leading the coordination of patient-centered care across the healthcare continuum. This position focuses on developing safe discharge plans through collaboration with patients, caregivers, and a multidisciplinary healthcare team, ensuring optimal transitions in care and efficient resource utilization. The role emphasizes improving patient outcomes, reducing length of stay, and preventing readmissions while maintaining compliance with healthcare regulations.
Responsibilities
- Effectively problem-solve and actively pursue resolution.
- Directly communicate with staff, physicians, patients, and families.
- Role model leadership behavior through courtesy, respect, and efficiency.
- Coordinate patient care processes to achieve desired quality outcomes and identify/control inappropriate resource utilization.
- Facilitate patient and family education and promote continuity of care to achieve optimal patient outcomes.
- Review the patient plan of care with the multi-disciplinary team and facilitate care conferences for complex cases.
- Communicate in the medical record and verbally with the team to coordinate interventions and facilitate continuity of care.
- Engage in daily communication and collaboration with patient care staff for continuous assessment and planning.
- Function without direct supervision, organizing assignments for maximum productivity.
- Adhere to name badge/dress code compliance.
- Demonstrate knowledge of federal and state regulations related to utilization management and managed care.
- Consult with physician section leaders for cases where continued stay is not appropriate.
- Communicate LOS and financial information to the department director.
- Integrate assessment of post-hospital services and determine appropriate discharge plans for complex cases.
- Educate patients/families about options within the determined level of care.
- Facilitate timely completion of orders prior to patient transfer to the next level of care.
- Collaborate with various stakeholders to determine discharge plans that benefit the patient.
- Report relevant information to staff assuming responsibility in the next level of care.
- Interface with department directors and patient representatives to identify potential QA or risk issues.
- Participate in departmental SQI projects.
Requirements
- Associate's Degree (or higher) in Nursing.
- Current, unrestricted RN license in the state of residence.
- 3+ years of experience in a hospital, acute care, or direct care setting.
- Intermediate level of proficiency to type and navigate a Windows based environment.
Nice-to-haves
- Bachelor of Science in Nursing (BSN) (or higher).
- Background in managed care.
- Case management experience.
- Certified Case Manager (CCM).
- Experience or exposure to discharge planning.
- Experience in utilization review and concurrent review.
- Knowledge/understanding of community resources, policies, and procedures.
- Knowledge of Utilization Review, Medicare Requirements processes, and State and Federal regulations.
Benefits
- Comprehensive benefits package.
- Incentive and recognition programs.
- Equity stock purchase.
- 401k contribution.
