UnitedHealth Group Telephonic RN Case Manager - Greensboro, NC or St. Louis, MO in Winston Salem, North Carolina

Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. This is the place to do your life's best work.(sm)

The Telephonic Case Manager will telephonically manage members, primarily working with our Heart Failure member population. The position is located in our Greensboro, NC or St. Louis, MO office. The hours will be normal business hours, Monday - Friday, with an expectation to work occasional weekends and holidays. Opportunity to Telecommute / work from home once training and mentoring are completed and metrics are being met.

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

  • 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

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 licensure. (Application fees and filing costs paid for by UHG)

Required Qualifications:

  • Current, unrestricted RN license in the state of North Carolina or Missouri

  • 3+ years of experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company

  • Proficient level of experience with Microsoft Word, with the ability to navigate a Windows environment

  • Multiple state licensure (in addition to Compact License if applicable) or ability to obtain multiple state nursing licenses required

Preferred Qualifications:

  • Bachelor's Degree or greater

  • A background in managed care

  • Case Management experience

  • Certified Case Manager (CCM)

  • Experience / exposure with discharge planning

  • Home health experience

  • Cardiac nursing experience

  • Critical care experience

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

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.

Job Keywords: Registered Nurse, RN, case manager, case management, care coordinator, CCM, managed care, telephonic, Greensboro, NC, North Carolina, cardiac, heart failure, critical care, home health