RN Telephonic Case Manager - Kidney Resource Services

UnitedHealth Group - Phoenix, AZ3.6

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 for the Kidney Resource Services program, 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 includes some evening hours where you will be expected to work until approximately 8pm, based on member availability. For example: 11am-8pm OR a split shift 8am-2pm and then 5pm-8pm. Candidates must reside in the Mountain or Pacific Time zones***

You’ll enjoy the flexibility to telecommute* from anywhere within the Mountain or Pacific Time Zones 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
This position will require active and unrestricted Nursing licensure in multiple US States. Selected candidate must be willing and able to obtain and maintain multiple state licensures (application fees and filing costs paid for by UHG).

Required Qualifications:
Active, unrestricted RN license in your state of residence
Multiple state licensures (in addition to Compact License if applicable) or ability to obtain multiple state nursing licenses required
2+ years of RN experience in a hospital, acute care, or direct care setting, or experience as a Telephonic Case Manager for an insurance company
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
Must reside in the Mountain or Pacific Time Zone

Preferred Qualifications:
Diabetic educator experience
Renal, Chronic Kidney Disease or Dialysis Care experience
Certified Case Manager (CCM)
Experience with discharge planning
Experience in utilization review, concurrent review and/or risk management
Telephonic case management experience
Bilingual Skills (fluency in Spanish, Mandarin, Chinese, etc.)
RN license in a compact RN license state

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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)

  • 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.