Complex Care Manager RN - Charlottesville, VA Market

UnitedHealth Group•Charlottesville, VA

5h•Remote

About The Position

The Complex Care Manager, RN will be managing complex members and is responsible for facilitating, promoting and advocating for the enrollees’ ongoing self-sufficiency and independence. This position is responsible for assessment and planning for an identified group of patients (High risk stratification). Care Manager will manage the care of members in their homes or other community settings by completing telephonic and or face to face health risk assessments and coordinating patient care, focusing on disease management and keeping members healthy and independent. The care manager will provide clinical and medical management services, including care management, health assessments, interventions, and discharge planning. Work is generally self-directed and not prescribed; so, it will be important to function in a less structured work environment.

Requirements

Current, unrestricted RN licensure in the state of Virginia
2+ years of recent experience in case management, home care, long term care and/or experience in acute or rehab care setting
1+ years of experience directly working with individuals with complex medical or behavioral needs
Basic level of proficiency in Microsoft Office suite applications (Word, Excel, Outlook/Email, Internet), including the ability to type and talk at the same time and toggle between multiple applications
Willingness to travel (up to 25%25) within a designated geographical region of Virginia for home/site visits
Driver’s license and access to reliable transportation and proof of automobile insurance for vehicle being used
Broadband internet capability from home office

Nice To Haves

CCM certification
Experience with Medicare and/or Medicaid
Experience with complex populations
Managed care/case management experience

Responsibilities

Engaging members/families telephonically and/or face to face to coordinate services, community resources, and treatment needs
Delivering a holistic approach to coordinated care based on the member’s needs using a person centered philosophy
Identifying early risk factors and conducting ongoing assessments and documenting in an electronic file
Creating, reviewing and revising care plans and focusing on a holistic approach
Functioning as an advocate for member
Collaborating with the member's PCP to deliver and coordinate necessary services
Building relationships with members and their families; assisting them with coordination of health choices
Ensuring cases are documented in a timely manner
Coordination with other state agencies, community resources and providers
Act as the primary point of contact for Members and the Interdisciplinary Care Team (ICT)