RN Field Case Manager
UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
Apply for this position with your eyes wide open. Click here to view the Realistic Job Preview: UHC Community State Field_Based_Case_Manager.pdf
Responsibilities for Case Managers include:
- Spend 85% of time in the field in Kent/Sussex Counties assessing 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
- Making referrals to outside sources
- Coordinating services as needed (home health, DME, etc)
- Educating members on disease processes
- Encouraging members to make healthy lifestyle changes
- Documenting and tracking findings
- 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
What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in 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.
Long Term Care Experience Preferred
Positions in this function include RN (with current licensure) and LPN/LVN roles that 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). 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.
- Generally work is self-directed and not prescribed.
- Works with less structured, more complex issues.
- Serves as a resource to others.
Requirements:
- Current, unrestricted RN or LPN license in the State of Delaware
- 2+ years experience in a hospital setting, acute care, direct care experience or experience as a Case Manager for an insurance company
- Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment
Additional Assets Preferred:
- Bachelor's Degree
- A background in managed care
- Certified Case Manager (CCM)
- Experience/exposure with discharge planning
- Experience in utilization review, concurrent review and/or risk management
- Strong organizational skills and multitasking abilities will be keys to success
UnitedHealthcare Community State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community State.
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
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.
