RN Field Case Manager
UnitedHealth Group • Phoenixville, PA3d • $60,200 - $107,400 • Onsite
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RN Field Case Manager, Care at Home - Berks & Chester Counties, PA
UnitedHealth Group•Phoenixville, PA
•$60,200 - $107,400•Onsite
About The Position
Optum Home & Community Care’s Care at Home (CAH) Dual Special Needs Plan (DSNP) program coordinates clinical care for patients in their residences. The program combines Optum-trained clinicians and an interdisciplinary care team to deliver individualized interventions, annual evaluations, longitudinal visits for higher-risk beneficiaries, care coordination during transitions from hospitals or nursing homes, and ongoing care management. Registered Nurses in the program work primarily in patients’ homes as part of a care team that includes a Nurse Practitioner, Behavioral Health Advocate, Care Navigator, and other supporting team members. They provide patient care through in-home visits, telephone outreach and consultations, and interdisciplinary team activities. The RN may provide care, initiate and update care plans, and educate and counsel patients to promote and maintain health throughout the life span. The role includes managing medical, behavioral, and social determinants of health needs and coordinating care in accordance with applicable state and federal regulations and nursing standards of care. Clinical management is conducted collaboratively with other care team members. The role is field-based and requires travel up to 75% of the time, primarily to patient homes. The position offers an annual salary range of $60,200 to $107,400 based on full-time employment and a $5,000 sign-on bonus for external candidates. A comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution are also offered, subject to eligibility requirements.
Requirements
- Active, unrestricted RN licensure in the state of residence and state of assignment.
- At least 2 years of relevant experience.
- Experience assessing the medical needs of patients with complex behavioral, social, and/or functional needs.
- Ability to work with diverse care teams in varied settings, including non-clinical settings such as patient homes.
- Ability to travel up to 75% of the time for field-based work.
- Valid driver’s license.
- Ability to physically navigate home settings and lift 30 pounds.
- Reliable transportation for commuting to member homes.
- Solid computer skills, including use of electronic medical records.
Nice To Haves
- Bilingual in English and Spanish.
- Experience in a home health care or hospice setting.
- Certified Case Management (CCM) certification.
- Effective time management and communication skills.
Responsibilities
- Assess patients’ health status within the scope of licensure and at the frequency established in the model of care.
- Establish goals to meet identified health care needs.
- Plan, implement, and evaluate responses to the plan of care.
- Collaborate with the interdisciplinary team to engage resources and strategies addressing medical, functional, and social barriers to care.
- Work closely with mental health clinicians to bridge the gap between mental and physical health.
- Review the Daily On Call Report to monitor assigned patients contacting Urgent Care and schedule them with an APC or RN as clinically indicated.
- Consult with patients’ primary care physicians, specialists, and other health care professionals as appropriate.
- Assess patients’ needs for community resources and make appropriate service referrals.
- Facilitate transitions within and between health care settings in collaboration with primary care and other treating physicians.
- Complete accurate documentation in patients’ electronic medical records.
- Counsel and educate patients and family members during visits on health maintenance, disease prevention, condition trajectory, and follow-up needs.
- Verify and document patient or family understanding of the condition, care plan, and follow-up recommendations.
- Participate actively in organizational quality initiatives.
- Participate in collaborative interdisciplinary team meetings to optimize clinical integration and the efficiency and effectiveness of care delivery.
- Initiate internal and external referrals as clinically indicated.
- Maintain credentials essential for practice, including licensure, applicable certification, and continuing education units.
- Demonstrate commitment to the organization’s mission, core values, and goals, incorporating compassion, integrity, performance, innovation, and relationships into patient care.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs, subject to eligibility requirements.
- Equity stock purchase, subject to eligibility requirements.
- 401(k) contribution, subject to eligibility requirements.
- $5,000 sign-on bonus for external candidates.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
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