Telephonic RN Case Manager

UnitedHealth Group
Full time
United States
Hiring from: Anywhere

Telephonic RN Case Manager – 11:00am – 8:00pm CST Shift

  • Requisition Number: 909902

  • Career Area: Clinical

  • Location: Richardson, TX or Remote, US

Compassion. It’s the starting point for health care providers like you and it’s what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you’re also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life’s best work.SM

For those who want to invent the future of health care, here’s your opportunity. We’re going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life’s best work.(sm)

As an RN Telephonic Nurse Case Manager, you will be responsible for clinical operations and medical management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating. You will also be responsible for providing health education, coaching and treatment decision support for members.

The schedule for this position is Monday-Friday, 11:00am – 8:00pm CST (after applicable training). Candidates in different time zones would need to adjust hours to align with that CST schedule.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Making outbound calls to assess members’ current health status

  • Identifying gaps or barriers in treatment plans

  • Providing patient education to assist with self-management

  • Interacting with Medical Directors on challenging cases

  • Coordinating care for members and services as needed (home health, DME, etc.)

  • Educating members on disease processes

  • Encouraging members to make healthy lifestyle changes

  • Utilizing Milliman criteria to determine if patients are in the correct hospital setting

  • Making “welcome home” calls to ensure that discharged member receive the necessary services and resources

  • Documenting and tracking findings

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:

  • Active, unrestricted RN license (compact state highly preferred)

  • 3+ years of clinical experience (any setting)

  • Computer proficiency utilizing MS Office (Word, Excel, PowerPoint and Outlook), including the ability to type and talk at the same time while navigating a Windows environment

  • Must reside in a location that can receive a UnitedHealth Group approved high speed internet connection or can leverage existing high – speed internet service

  • Access to dedicated work space from home for in home office set up

If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employee must comply with any state and local masking orders.

Preferred Qualifications:

  • BSN

  • Certified Case Manager (CCM)

  • ICU, Cardiology or Critical Care experience

  • Strong working knowledge chronic medical diagnoses (CHF, COPD, diabetes, etc.)

  • Experience with discharge planning

  • Telephonic case management experience

  • Experience in a remote position

Additional Job Detail Information

Requisition Number: 909902

Business Segment: Enterprise Clinical Services

Employee Status: Regular

Job Level: Individual Contributor

Travel: No

Overtime Status: Exempt

Schedule: Full-time

Shift: Day Job

Telecommuter Position: Yes

How to apply

To apply for this job you need to authorize on our website. If you don't have an account yet, please register.

Post a resume

Similar jobs

LISW – Licensed Clinical Social Worker – OH Remote AbleTo is the leading provider of high quality, technology-enabled behavioral health care. AbleTo believes that everyone deserves access to high-quality care, and offers a suite of technology-enabled services to empower people...
United States
Hiring from: Anywhere
Cardio-Thoracic Medical Coding QA Analyst (Per Diem) Job Locations: US-Virtual/Remote Job ID: 2021-2151 # of Openings: 1 Category: Medical Coding Minimum Hours: 20 Overview Primary Care Professional Fee E/M Medical Coding Specialist Are you interested in joining one of the...
United States
Hiring from: Anywhere
Tower Health
Full time
ED Medical Coder Req. Number: 2021-34964 Shift: Day Work Schedule: 7AM-330PM Hours: 80 hours per pay period Address: 420 S 5th Ave City, State: West Reading, PA Department: HIM Coding Overview Tower Health is a strong, regional, integrated healthcare provider/payer...
United States
Hiring from: Anywhere