RN Call Us First Case Manager - Remote ID-14231
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.
Position in this function is under minimal supervision, responsible for ensuring the continuity of care in the outpatient setting utilizing the appropriate resources within the parameters of established contracts and patients' health plan benefits. Facilitates continuum of patients' care utilizing advanced nursing knowledge, experience and skills to ensure appropriate utilization of resources and patient quality outcomes. Performs care management functions on-site and telephonically as the need arises. Works in conjunction with the care team and PCP as care team leader to develop a patient centered plan of care.
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If you are located in PST, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities
- Prioritizes patient care needs upon initial visit and addresses emerging issues
- Meets with patients, patients' family and caregivers as needed to discuss care and treatment plan
- Identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings
- Consults with physician and other team members to ensure that care plan is successfully implemented
- Coordinates treatment plans with the care team and triages interventions appropriate to the skill set of the team members. Uses protocols and pathways in line with established disease management and care management programs in order to optimize clinical outcomes and minimize unnecessary institutional care
- Monitors and coaches patients using techniques of motivational interviewing and behavioral change to maximize self-management
- Oversees provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc. in order to maintain continuity of care
- Works in coordination with the care team and demonstrates accountability with patient management and outcome
- Discusses Durable Power of Attorney (DPOA) and advanced directive status with patient and PCP when applicable
- Maintains effective communication with the physicians, hospitalists, extended care facilities, patients and families
- Provides accurate information to patients and families regarding resources available to them through health plan benefits, community resources, and referrals
- Participates actively in Monthly Care Management Department meetings and daily huddles
- Documents pertinent patient information and Care Management Plan in Electronic Health Record
- Coordinates care with central departments on assigned patient caseload, including, inpatient, long term care facilities, adult family homes, and home health agencies
- Demonstrates a thorough understanding of the cost consequences resulting from Care Management decisions through utilization reports and systems such as Health Plan Benefits, CM dashboards and reports
- Maintains concise and accurate documentation that supports effective and efficient management of care plans to decrease Emergency and hospital readmissions
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
- Graduation from an accredited school of nursing
- Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross)
- 3+ years of experience in a clinical setting
- Washington State Registered Nurse or Multistate (Compact) license.
- Basic Life Support (BLS) for Healthcare providers (AHA)
Preferred Qualifications
- Bachelor of Science in Nursing, BSN
- Telehealth certification
- 3+ years of experience working in acute care
- 1+ year(s) Previous care management, utilization review or discharge planning experience
- HMO Experience
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
The salary range for this role is $59,500 to $116,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
