We're making a strong connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today!
Positions in this function require various nurse licensure and certification based on role and grade level. Licensure includes RN and LPN/LVN, depending on grade level, with current unrestricted licensure in applicable state. These roles identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for members. Includes Health Coach, Health Educator, and Health Advocate roles that require an RN. *Employees in jobs labeled with 'SCA' must support a government Service Contract Act (SCA) agreement.
- Generally work is self-directed and not prescribed
- Works with less structured, more complex issues
- Serves as a resource to others
* Make outbound calls and receive inbound calls to assess members' current health status
* Identify gaps or barriers in treatment plans
* Provide patient education to assist with self-management
* Make referrals to outside sources
* Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction
* Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels
This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Strong computer and software navigation skills are critical. You should also be strongly patient-focused and adaptable to changes.
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.
- Current, unrestricted RN license in the state of employment
- 3+ years of experience in a hospital, acute care or direct care setting
- Must be able to type and have the ability to navigate a Windows based environment
- Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive VoiceResponse (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
* A background in managed care
* Case management experience
* Certified Case Manager (CCM)
* Experience or exposure to discharge planning
* Experience in utilization review, concurrent review or risk management
* Previous experience in a telephonic role
Answer the call to use your diverse knowledge and experience to make health care work better for our patients. Join us and start doing your life's best work.(sm)
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
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: Case Manager, RN, registered nurse, discharge, Boulder, CO, Colorado
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