Case Manager RN

UnitedHealth Group•Phoenix, AZ

4d•$60,200 - $107,400•Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. We are looking for an RN Care Coordinator as an addition to the Optum Insight ACO Practice Extend Team. You will work alongside our Care Team’s Clinical Pharmacist and Clinical Administrative Coordinator to improve the health outcomes of the patients we serve. The RN Care Coordinator is responsible for managing patients attributed to provider practices participating in the Optum Insight ACO. The RN Care Coordinator focuses on care transitions, high risk patient management, referral coordination, and appropriate site-of-service utilization. This role includes high-volume telephonic outreach, patient education, and coordination with primary care providers (PCPs), specialists, and the Practice Extend care team to ensure high-quality care delivery. You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Requirements

Bachelor’s degree
Current, active, unrestricted Registered Nurse (RN) license in a Compact License state within the US
3+ years of experience in Case Management and/or Care Coordination
Advanced level of proficiency in Microsoft Office, particularly Excel and PowerPoint
Advanced level of proficiency typing and navigating a Window-based environment simultaneously
Ability to work 1 late shift per week (10 am -7pm), standard schedule is 8am-5pm (times reflect the time zone business hours assigned – Central, Mountain, or Arizona)

Nice To Haves

Spanish/English Bilingual
Case Management Certification
Experience in a high-volume outreach or outbound call center environment
Experience in managed care and/or population health management
Ability to quickly learn and manage multiple clinical systems simultaneously
Adaptable, flexible, and able to incorporate frequent process changes into established workflows within a fast-paced, dynamic environment

Responsibilities

Work with a Care Team of a Clinical Pharmacist and Clinical Administrative Coordinator to support patient and provider engagement across care transitions management, care coordination, and medication management activities
Facilitate communication of inpatient discharge information to primary care offices using appropriate technology tools
Conduct post-discharge outreach for inpatient and emergency department visits, including medication reviews, scheduling timely follow up appointments, and providing education on discharge instructions and appropriate sites of care
Guide patients in accessing high-quality, cost-effective specialist referrals
Support high-risk patients by coordinating and scheduling PCP and/or specialist appointments
Provide patients with benefit information and resources upon request
Communicate with provider offices to resolve patient care issues and facilitate communication between practice staff and care team
Build and maintain strong relationships with participating provider practices by communicating program goals, patient needs, and value-based care opportunities
Facilitate and/or lead provider-facing meetings, including onboarding meetings and ongoing collaboration meetings