Field RN Case Manager
UnitedHealth Group • Milwaukee, WI4d • $60,200 - $107,400 • Onsite
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Field RN Case Manager, Optum Care at Home - Milwaukee, WI
UnitedHealth Group•Milwaukee, WI
•$60,200 - $107,400•Onsite
About The Position
The Field Registered Nurse supports patient care management for members in the Optum Dual Special Needs Plan (DSNP) at Home program. This longitudinal, integrated program coordinates clinical care in members’ places of residence. The RN provides oversight, guidance, and support for care plans developed with the interdisciplinary care team, health plan, and other health care vendors to meet each patient’s needs. Under the direct supervision of an RN/APC or MD, the RN coordinates and provides appropriate levels of care and performs clinical operations and medical management activities across the continuum, including assessment, planning, implementation, coordination, monitoring, and evaluation. The role includes case management, in-home assessments and visits, care coordination, medical management consulting, transition-of-care management, health education, coaching, and treatment decision support. This is a field-based position in Milwaukee, Wisconsin. The position offers a $7,500 sign-on bonus to external candidates.
Requirements
- Active, unencumbered RN license.
- At least 3 years of experience in a hospital, acute care, or direct care setting.
- Experience with EMR systems and navigating a Windows-based environment.
- Driver’s license and access to reliable transportation to travel to client and/or patient sites within a designated area.
Nice To Haves
- Bachelor of Science in Nursing (BSN).
- Certified Case Manager (CCM) certification.
- Case management experience.
- Experience working in home health or an in-home setting.
- Experience with chronically ill patients and families.
- Understanding of Medicare, Medicaid, and health plan benefit structures.
Responsibilities
- Review consumer health records and current health status, including health risk scores, to identify risks and determine next steps.
- Conduct initial and ongoing nursing assessments in the home setting.
- Receive information from consumers about symptoms and questions; interview them to understand cause and effect, review health history, and determine health literacy.
- Evaluate consumer data for inconsistencies and adherence to evidence-based guidelines across health care and psychosocial or socioeconomic dimensions.
- Identify and prioritize care gaps and develop plans of care with short- and long-term goals.
- Assess consumers’ willingness to engage in the plan of care and readiness for change.
- Identify interventions and resources to address consumer needs and care gaps, including psychosocial, transportation, and long-term-care resources.
- Document plans of care in appropriate EHR systems and enter data in the specified format.
- Maintain consumer engagement by establishing rapport, demonstrating empathy, and building trusting relationships.
- Collaborate with primary providers and multidisciplinary teams to align goals and coordinate care.
- Provide ongoing support for advanced care planning.
- Reassess plans of care at appropriate intervals, including after significant changes in condition or achievement of goals.
- Operate in accordance with legal and regulatory requirements.
- Use evidence-based guidelines, medical necessity guidelines, practice and industry standards, best practices, and contractual requirements to make clinical decisions and support clinical outcomes and business results.
- Conduct home visits, manage transitions of care, and provide health education, coaching, and treatment decision support.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase plan.
- 401(k) contribution.
- $7,500 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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