At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
RN Case Managers in the Government Programs Stars Quality program connect with members telephonically to improve member outcomes while enhancing the quality of care.
Work Schedule:
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Full time position
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Operating hours (40 hrs./week): Monday - Friday, 8-hour shift between 8:00am - 5:00pm local time
If you are residing in Minneapolis, MN, Minnetonka, MN or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
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Assess the health status of members within the scope of licensure and with the frequency set forth in the program model, or as otherwise identified by the care manager and member
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Establish goals to meet the identified health care quality needs, addressing and closing quality gaps in care as appropriate
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Plan, implement, and evaluate responses to the plan of care interventions
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Work collaboratively within a multidisciplinary team to engage resources and strategies to address medical, behavioral, and social barriers to care
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Works closely with National Personal Pharmacist Program Team 9NP3) to address member medication and adherence needs
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Consult with the patient's PCP, specialists, or other health care professionals as appropriate
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Assess patient needs for appointment scheduling and connecting with community resources, making appropriate referrals for service
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Follow up with members post transition from hospital or SNF to home in collaboration with the goals of the primary care physician and other treating physicians
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Completely and accurately document in the required clinical platform
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Provide members and care givers with counseling and education regarding health maintenance, preventive care, condition trajectory and need for follow-up
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Verify and document patient and/or caregiver understanding of condition, plan of care and follow up recommendations
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Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness
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Maintain credentials essential for practice
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Demonstrate a commitment to our mission, core values and goals including the ability to integrate values of compassion, integrity, performance, innovation, relationships, and inclusion in the care provided to our members
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
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High School Diploma/GED
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Current and unrestricted Nursing licensure in your state of residence
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2+ years of experience as a Licensed Nurse (RN or LPN/LVN)
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2+ years of experience in assessing the medical needs of patients with complex medical, behavioral, and/or social needs
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2+ years of experience working within interdisciplinary care teams
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Intermediate level of computer skills (Microsoft Suite)
Preferred Qualifications:
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Certified Case Manager (CCM)
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6+ months of Case Management experience
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Medicare or Medicaid quality (Stars, HEDIS, Pharmacy) experience
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Proven excellent administrative and organizational skills and the ability to effectively communicate with members and their caregivers
Telecommuting Requirements:
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Designated quiet workspace in your home (separated from non-workspace areas) and the ability to secure and maintain Protected Health Information (PHI) and/or Protected Information (PI)
- All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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