Case Manager RN - Remote Nationwide

UnitedHealth Group•Minnetonka, MN

1d•$60,200 - $107,400•Remote

About The Position

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. RN Case Managers in the Government Programs Stars Quality program connect with members telephonically to improve member outcomes while enhancing the quality of care.

Requirements

High School Diploma/GED
Current and unrestricted Nursing licensure in your state of residence
2+ years of experience as a Licensed Nurse (RN or LPN/LVN)
2+ years of experience in assessing the medical needs of patients with complex medical, behavioral, and/or social needs
2+ years of experience working within interdisciplinary care teams
Intermediate level of computer skills (Microsoft Suite)
Designated quiet workspace in your home (separated from non-workspace areas) and the ability to secure and maintain Protected Health Information (PHI) and/or Protected Information (PI)
All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Nice To Haves

Certified Case Manager (CCM)
6+ months of Case Management experience
Medicare or Medicaid quality (Stars, HEDIS, Pharmacy) experience
Proven excellent administrative and organizational skills and the ability to effectively communicate with members and their caregivers

Responsibilities

Assess the health status of members within the scope of licensure and with the frequency set forth in the program model, or as otherwise identified by the care manager and member
Establish goals to meet the identified health care quality needs, addressing and closing quality gaps in care as appropriate
Plan, implement, and evaluate responses to the plan of care interventions
Work collaboratively within a multidisciplinary team to engage resources and strategies to address medical, behavioral, and social barriers to care
Works closely with National Personal Pharmacist Program Team 9NP3) to address member medication and adherence needs
Consult with the patient's PCP, specialists, or other health care professionals as appropriate
Assess patient needs for appointment scheduling and connecting with community resources, making appropriate referrals for service
Follow up with members post transition from hospital or SNF to home in collaboration with the goals of the primary care physician and other treating physicians
Completely and accurately document in the required clinical platform
Provide members and care givers with counseling and education regarding health maintenance, preventive care, condition trajectory and need for follow-up
Verify and document patient and/or caregiver understanding of condition, plan of care and follow up recommendations
Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness
Maintain credentials essential for practice
Demonstrate a commitment to our mission, core values and goals including the ability to integrate values of compassion, integrity, performance, innovation, relationships, and inclusion in the care provided to our members