For nurses who prefer to blaze their own career path.
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
Field Case Manager, RN for SouthEast, WI area!
Serving millions of Medicare and Medicaid patients, Optum is the nation's largest health and wellness business and a vibrant, growing member of the UnitedHealth Group family. We're also the career home for Nurse Case Managers who bring compassion and passion, energy and focus to their work every day.
The Nurse Case Manager (NCM) supports the primary visiting provider (PVP) in assessing and managing the overall patient care management process. In addition, the Nurse Case Manager will identify and collaborate on innovative actions to meet the needs of Optum patients from both the health care and psychosocial / socioeconomic dimensions of care; as well as taking action for provision of services to meet the patient needs.
The NCM provides oversight, guidance and support for the patient care plan as developed in collaboration with the PVP. This care plan is based on the comprehensive history & physical completed by the PVP and the nursing assessment. The NCM uses both assessments and ongoing telephonic assessments to help guide treatment and care decisions of the team with a focus on trigger management to prevent adverse outcomes. In addition the NCM collaborates with the health plan and additional heath care vendors to meet the needs of the patient and also identifies services and vendors for needed care while navigating patient benefit plans. The Nurse Case Manager will ensure that all pertinent documentation is in the medical record in a manner compliant with CMS, Optum and client requirements.
Key responsibilities of the Nurse Case Manager include:
- Conduct initial and ongoing assessments utilizing nursing assessment skills
- Develop and implement an effective care plan to meet the needs of Optum community patients from both the health care and psychosocial / socioeconomic dimensions of care
- Advocate for the patient in all activities including nursing assessments, care coordination, care plan development, and communication.
- Identify triggers for hospitalization and develop (in collaboration with members of the care team) an effective care plan
- Communicate and collaborate with other members of the health care team (PCP, PVP, CMA, health plan) to coordinate all needed care and service
- Provide ongoing patient education leveraging written material as available/approved by the health plan
- Provide ongoing support of patients with advance care planning
- Provide 24/7 support for the PVPs as needed
- Active un-encumbered license to practice nursing in the state of Wisconsin
- A minimum of 2-3 years nursing experience working in a Nursing Home or in an acute care setting
- A minimum of 1 year of case management experience
- Basic knowledge of computers and cell phones
- Familiarity with ICD-9 and CPT-4 coding
- Excellent organizational skills with the ability to multi-task
- Must have experience working within a team environment
- Bi-lingual or multi-lingual a plus.
- Managed care, utilization management, risk management, quality management, case management experience helpful.
- Case Management certification is a plus.
- Understanding of Medicare, Medicaid and Health Plan benefit structures beneficial.
What happens when you join our expanding, Fortune 17 organization? You will share our mission to improve the health of others and help heal the health care system. You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
If you want more meaning in your career - as a clinician or a business professional â€“ take this opportunity and apply. It's the first step in a new career that will enable you to do your life's best work.
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.
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.
Job Keywords: Job, Registered Nurse, Nurse Case Manager, Case Manager, RN, long term care, LTC, Assisted Living, Nursing Home, Primary Care, Home Health, Home Care, Community, (ADD STATE AND CITY TO INCLUDE ABBREVIATIONS)
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Job Category: Nurse
Job Reference Code: UHG-557819
Position Type: Full-Time