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Care Manager RN - Per Diem

$58,302 - $114,296/Yr

UnitedHealth Group - Bangor, ME

posted about 1 month ago

Full-time - Entry Level
Remote - Bangor, ME
Insurance Carriers and Related Activities

About the position

The Care Manager, RN is responsible for leading the coordination of patient-centered care across the healthcare continuum. This role involves developing safe discharge plans in collaboration with patients, caregivers, and a multidisciplinary healthcare team, ensuring optimal transitions in care and appropriate post-discharge services. The Care Manager aims to improve patient flow, reduce length of stay, and minimize readmission risks through effective clinical care coordination and resource utilization.

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 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.
  • Interface with department directors and Risk Management 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 of community resources, policies, and procedures.
  • Knowledge of Utilization Review, Medicare Requirements processes, and State and Federal regulations pertaining to Utilization Review and Discharge Planning.

Benefits

  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution
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