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RN Case Manager - Telecommuter - Anywhere

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Company: UnitedHealth Group

Location: Bellevue, WA

Date Posted: July 5, 2014

Source: UnitedHealth Group

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)

Work from home Telephonic RN Case Manager: High Risk Case Management

**Successful candidate will need to live within the boundaries of the state of Washington**

As a 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. This may include case management, disease management, coordination of care and medical management consulting. You will also be responsible for providing health education, coaching and treatment decision support for members. Case Managers work in a variety of settings: in the community providing proactive care coordination to individuals and ...

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)

Work from home Telephonic RN Case Manager: High Risk Case Management

**Successful candidate will need to live within the boundaries of the state of Washington**

As a 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. This may include case management, disease management, coordination of care and medical management consulting. You will also be responsible for providing health education, coaching and treatment decision support for members. Case Managers work in a variety of settings: in the community providing proactive care coordination to individuals and support to their families or in telephonic care management position.

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
* 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
* Make High Risk Case Management calls to members that are high risk for utilization of services including acute hospital admissions
* Coordinate and facilitate Case Managment rounds with the Washington interdisciplinary team
* May require field visits, as needed

Requirements

QUALIFICATIONS:

* Current, unrestricted RN license for the state of Washington
* A minimum of 3 years of RN level nursing experience, preferably in a hospital setting, including acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
* A minimum of 2 years of case management experience
* CCM required (will consider candidates in process)
* Work from home position with the candidate residing in the state of Washington
* PC proficiency in a Windows environment, including the ability to navigate multiple screens and document calls while on the phone with members
* Washington Health Plan experience
* Demonstrated knowledge of Medicaid rules and regulations
* A background in Managed Care
* Disease Management experience
* Experience with Discharge Planning
* Strong organizational skills and multitasking abilities will be keys to success

Desired Assets:

* BSN

OptumHealth 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.

OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.

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.

Keywords: Registered Nurse, RN, Case Management, Case Manager, Medicaid, High Risk

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