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RN Maternity Case Manager - Telecommute in Middle Tennessee job in Nashville at UnitedHealth Group

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RN Maternity Case Manager - Telecommute in Middle Tennessee at UnitedHealth Group

RN Maternity Case Manager - Telecommute in Middle Tennessee

UnitedHealth Group Nashville, TN Full Time
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UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care.
As a Telecommute Field - Based Healthy First Steps HSS Clinical Coordinator, you'll wear many hats, and work in a variety of environments supporting either the maternity or pediatric populations. Sometimes, you'll interact with members leaving the hospital, possibly with new medications or diagnoses. Perhaps you'll perform home visits, assisting members with safe, effective transitions from care environments to where they live. You may also act as an intermediary between providers and members serving in numerous roles, such as educator, evaluator, service coordinator, community resource researcher and more. The result? Fewer hospitalizations, ER visits and costly service gaps; and a less stressed, more effective health care system for us all. Want more flexibility, want more autonomy? Work from your own home and coordinate a visiting schedule that is mutually beneficial to you and the members we serve.

If you are located within the Middle Tennessee, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Work independently to identify priorities, make decisions, and complete work to meet established objectives; Works with minimal guidance; seeks guidance on only the most complex tasks  
  • Assess customer needs and requirements focusing on the customer as an individual while identifying support solutions for standard, and non-standard requests and problems
  • Complete assessments as defined in Job Aids, and timely at appropriate intervals
  • Make referrals to internal/external partners based on assessment/need/individual request per process
  • Solves moderately complex problems and/or conducts moderately complex analyses applying clinical knowledge/skills to a range of moderately complex activities
  • Translate concepts into practice
  • Provide explanations and information to others on difficult issues
  • Coach, provide feedback and guide others
  • Work on new projects or team functions as needed
  • Work cross-functionally and coordinate with others internally or externally to gather information; overcome challenges to obtaining needed information when needed 
  • Adhere to applicable internal and external/governmental guidelines and requirements (e.g., legal, regulatory compliance)
  • Able to participate in travel, for example, but not limited to individual homes, provider locations, agencies, state partner locations, or others where there is a business need
  • Perform other related functions as assigned
  • Be responsible for functions in areas such as health services, clinical services, and delivery of clinical care 
  • Focus on medical, behavioral, and social determinants of health factors that improve the well-being of individuals, mothers and children 
  • Be self-directed with less structured work, dealing with complex issues while serving as a resource for others
  • Have varied tasks according to the needs of the individual(s) being served
  • Use your proficiency with computers, as well as excellent verbal and written communication are document clinical plans and outcomes 
  • Demonstrate flexibility and eagerness to learn and create new processes

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Associates degree or higher
  • Hold current unrestricted RN licensure in the State of Tennessee
  • 3+ years of experience in Antepartum, High Risk OB care, Labor and Delivery and/or Postpartum Care in a hospital, home care or provider office setting
  • 2+ years clinical experience in a hospital, acute care, home health /hospice, direct care or case management
  • 2+ years of experience in provider interfacing
  • 2 + years of professional experience with Microsoft Office (PowerPoint, Word, Excel, & Outlook)
  • Vast knowledge of women's health and maternity conditions and treatments
  • Access to highspeed internet service
  • Private space for work at home office
  • Reliable transportation and ability to travel to member homes, provider offices, or other locations within assigned service delivery area
  • Reside in Middle Tennessee
  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

Preferred Qualifications:

  • CCM certification
  • 2+ years of experience in Case Management 
  • 2+ years of experience in Managed Care
  • Experience in Maternity Case Management 
  • Experience in Medicaid, Medicare, Managed Care 
  • Experience with electronic charting
  • Experience with arranging community resources
  • Experience in Complex Clinical and/or Case Management
  • Experience in field-based work
  • Working knowledge of State rules for program-specific eligibility and requirements
  • Proficient with relevant computer systems and platforms and ability to operate and integrate those systems (Intranet, Internet, SharePoint; ICUE, Microsoft Teams)

To protect the health and safety of our workforce, patients, and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state, and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

Job Keywords:  RN Maternity Case Manager, HSS Clinical Coordinator, RN, Registered Nurse, Peds, L&D, Maternal Child Health, OB nurse, Labor and Delivery, Nashville, Davison County, Rutherford County, Williamson County, TN,  Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote


Recommended Skills

  • Assessments
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  • Critical Care
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