Medical Behavioral RN Case Manager - Remote/Field

UnitedHealth Group•Layton, UT

3d•$60,200 - $107,400•Onsite

About The Position

The OptumCare Medical Behavioral Integration Nurse Case Manager is a direct clinical liaison between OptumCare/Care Delivery organization customers and the clinical network. The position uses a collaborative process to assess plans, implement and coordinate services, monitor care, and evaluate options that meet members’ health needs. Through education, communication, and available resources, the nurse promotes quality, cost-effective outcomes. This is a field-based position based in Layton, Utah, with local travel for patient home visits.

Requirements

Active and unrestricted license(s).
RN with at least 4 years of experience.
Proficient computer skills and good working knowledge of Microsoft Word.
Ability to maintain direct and open communication with all levels of the organization.
Ability to handle sensitive issues involving members and providers confidentially in accordance with HIPAA guidelines.
Initiative in achieving individual, team, and organizational goals and objectives.
Flexibility to assume responsibilities and tasks in a constantly changing work environment.
Ability to travel locally for patient home visits up to 75% of the time.
Live within a commutable distance of Layton, Utah.
Valid driver’s license and access to reliable transportation.

Nice To Haves

At least 2 years of experience in related field-based case management.
Experience in a medical/behavioral setting, such as a hospital, managed care organization, or joint medical/behavioral outpatient practice.
Experience with dual diagnoses involving mental health and substance abuse.
Experience coordinating benefits and using multiple groups and resources for patients.
Experience working with low-income populations.
Experience working with aged, blind, or disabled populations.
Clinical training experience.
Excellent customer-service skills.
Excellent interpersonal and problem-solving skills.
Strong teamwork and team-building skills.
Strong oral and written communication skills, particularly telephone skills.
Ability to function independently and responsibly with minimal supervision.

Responsibilities

Screen and identify members with high-risk, long-term chronic conditions who may benefit from care management, and monitor utilization as needed.
Conduct member evaluations and onsite visits in settings such as members’ homes, clinics, hospitals, and skilled nursing facilities; provide feedback on planned interventions and care-plan outcomes.
Perform comprehensive assessments, gather information from patients, caregivers, providers, and other relevant parties, and identify members who may benefit from care-management intervention.
Document assessment findings and develop individualized care plans in accordance with documentation requirements and CMS regulations.
Use advanced clinical skills to address members’ health, behavioral health, and psychosocial needs through coaching, education, communication, and available resources.
Document patient and family status, diagnoses, medications, treatment plans, goals, interventions, evaluation results, observations, and progress in the electronic medical record or proprietary database accurately and promptly.
Advocate for members and families so their needs and choices are represented and supported by the care team.
Attend interdisciplinary team meetings as needed and collaborate with providers to assess behavioral health concerns and refer members to appropriate community resources.
Use professional knowledge and critical-thinking skills to facilitate physician consultation on complex cases.
Apply nursing, counseling, or social-work theory, knowledge, ethics, methods, and interventions within the scope of licensure and job function.
Manage the assigned caseload efficiently and effectively.