Nursing careers at UnitedHealth Group are anything but ordinary. There’s an energy and excitement here, a shared mission to improve the lives of others as well as our own. A passion for excellence you won’t find anywhere else. We ask tough questions. We push ourselves and each other to find smarter solutions. The result is a culture of performance that’s driving the health care industry forward. Nursing here isn’t for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Learn more, and start doing your life’s best work.SM
RN Transition Care - Utilization Management for WellMed - San Antonio, TX
Be a part of our growing team!
Improve the quality of care for our patients.
WellMed is looking for RN Transition Care Managers (Case Managers) - UM Nurses for our growing team in San Antonio.
The RNs are responsible for utilization management and inpatient care management coordination and will perform reviews of current inpatient services, and determine medical appropriateness of inpatient and outpatient services by following medical guidelines and benefit determination. They will also identify, screen, track, monitor and coordinate the care of members with multiple co-morbidities, psychosocial needs, transition needs and develop a nursing plan of care as well as prospective, concurrent, and retrospective utilization review of inpatient services. The RNs act as an advocate for members and their families by linking them to other members of the care team to help them gain knowledge of their disease process and to identify community resources for continued growth toward the maximum level of independence. The RN is also responsible for the case management activities across the continuum of care including coordination of care, medical management consulting and may also provide health education, coaching and treatment decision support for members.
Bachelor's degree in Nursing, or Associate's degree in Nursing and Bachelor's degree in related field, or Associate's degree in Nursing combined with 4 or more years of experience.
Current, unrestricted RN license required, specific to the state of employment.
Case Management Certification (CCM) or ability to obtain CCM within one year of employment.
3 or more years of diverse clinical experience in caring for the acutely ill patients with multiple disease conditions.
WellMed is a healthcare delivery system serving more than 90,000 patients, primarily Medicare eligible seniors, in Texas and Florida through primary care clinics, multi-specialty clinics, and contracted medical management services. Headquartered in San Antonio, Texas, WellMed is an industry leader in medical risk management, highly effective disease management and chronic care programs, healthcare delivery services and more.
Our focus and mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. We are innovators in preventative healthcare, striving to change the face of healthcare delivery for seniors. Our providers and support staff are selected for their dedication to the senior population and focus on preventative, proactive patient care.
WellMed is now part of the OptumHealth division under the greater UnitedHealth Group umbrella.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
keywords: rn, registered nurse, case manager, case management, ccm, utilization management, um, ur, utilization review, san antonio, patient education, transition care, inpatient
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Job Category: Nurse
Job Reference Code: UHG-534273
Position Type: Full-Time