Job Information
UnitedHealth Group Case Manager RN Remote in Franklin, Indiana
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 to start Caring. Connecting. Growing together.
If you are located in INDIANA or OHIO, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
Assesses the healthcare, educational, and psychosocial needs of the patient and their family at the initial referral to case management
Designs individualized plan of care with the patient and develops a team approach by working collaboratively with the family, primary care provider and other members of the healthcare team to ensure coordination of services
Monitors and updates individualized plan of care for the patient using a team approach by working collaboratively with the family, primary care provider and other members of the healthcare team to ensure coordination of services
Implements clinical interventions based on evidence based clinical guidelines
Identifies and coordinates referrals and other community resources
Follows appropriate care management protocols, as assigned by provider
Implements system of care that closely monitors high risk patients to prevent / intervene early during acute exacerbations
Ensures therapies are arranged as directed by the practitioner and provides appropriate follow-up and monitoring as needed
Ensures medication reconciliation is completed and documented for all assigned patients according to Population Health guidelines
Performs patient follow-up calls for issues, feedback and continued follow-up needs, per care management protocol and recommended timelines
Assists with data collection and closing of care gaps and quality metrics as assigned and assists the healthcare team in meeting all of the quality metrics
Facilitates problem-solving with the patient/family to mobilize patient resources
Evaluates and refines the initial assessments and goal achievements in collaboration with the healthcare team
Advocates for patient/family in assisting the health care team in understanding patient’s rights
Works cohesively with the healthcare team in discharge planning to link patients with the most appropriate resources
Identifies opportunities for process improvement in all aspects of patient care
Other Functions
Attends meetings and participates on committees as requested
Reviews current literature and attends training sessions and seminars to keep informed of new developments in the field
Performs other related duties and responsibilities as directed
Understands and models AHN mission and UHG’s culture standards during all workplace interactions
Participates and collaborates with other members of the Population Health Team and during Pop Health initiatives, to better care and meet the needs of our AHN patients
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Current, unrestricted RN license in the state of employment
Active Compact RN License
2+ years of experience in a hospital, acute care or direct care setting
Preferred Qualifications:
BSN
Certified Case Manager (CCM)
Case management experience
Experience or exposure to discharge planning
Experience in utilization review, concurrent review or risk management
Experience in a telephonic role
A background in managed care
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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.
Diversity creates a healthier atmosphere: OptumCare 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.