Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

We are looking for a Case Manager RN as an addition to the team. The Case Manager RN drives Referral Management and appropriate sites of service, facilitates Care Transitions and Care for High-Risk patients; Collaborates with PCP, Specialists, and Spectrum Clinical Pharmacist to ensure appropriate, coordinated service delivery. This position integrates pharmacy management, care coordination, utilization management, and care transition management.

You’ll enjoy the flexibility to telecommute* from anywhere within OH, IN, or KY as you take on some tough challenges.

Hours: Monday – Friday – 9 AM – 5 PM with the ability to work 2 days until 7 PM

Primary Responsibilities:

• Work with a Care Team of a Clinical Pharmacist and Clinical Administrative Coordinator to support patient and provider engagement for Care Transitions Management, Care Coordination, and Medication Therapy Management
• Facilitate inpatient discharge information to Care Team and Primary Care Offices using appropriate technology tools
• Consult with patients who have had an inpatient discharge; facilitate scheduling transitions of care follow up appointments with PCP and/or specialists 
• Consult with patients who have had an ED discharge; facilitate scheduling follow-up appointments as needed; review post-discharge information with patients and educate on alternative sites of care
• Engage high-risk patients telephonically to schedule appointments with Clinical Pharmacist for Comprehensive Medication Reviews
• Prepare patient cases in workflow management platform for Clinical Pharmacist patient engagement
• Consult with patients identified as needing a specialist referral to recommend high quality, lower cost specialists
• Support high-risk patients by scheduling PCP and/or specialist appointments on their behalf
• Provide benefit information and resources to patients upon request
• Communicate with provider offices to problem-solve patient issues and/or facilitate communication between practice staff and Care Team
• Notify PCP and Care Team Clinical Pharmacist of relevant clinical information gathered during calls to patient that may affect the patient’s disease state or medication regimen
• Develop strong relationships with provider offices participating with Practice Extend program by communicating program goals, patient needs, and value-based opportunities
• Facilitate and/or lead meetings with provider offices for initial onboarding meetings and ongoing collaboration meetings

What are the reasons to consider working for UnitedHealth Group?   Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• More information can be downloaded at: http://uhg.hr/uhgbenefits

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:

• Bachelor’s Degree (Or Higher)
• Unrestricted licensure as a Registered Nurse for OH, IN or KY or a compact licensure
• 4+ years of facilitating comprehensive case management and/or care coordination experience
• 3+ years of experience in managing populations with complex medical or behavioral needs
• Intermediate level of proficiency with Microsoft Office, Outlook, and Teams applications, and ability to quickly learn clinical applications and multi system management
• Intermediate level of ability to type and navigate a Window-based environment simultaneously
• Able to travel up to 10% to local office(s) to accommodate business needs
• Ability to work flexible schedule, including evenings up to 7pm, to accommodate business needs

Preferred Qualifications:

• Prior experience in managed care and/or population health management
• Background in healthcare setting with an understanding of chronic conditions and best practices
• Spanish/English Bilingual 

Soft Skills:

• Strong communication skills with patients, providers, and other healthcare professionals
• Ability to provide proactive clinical feedback to enhance quality patient engagement and program growth
• Able to take initiative and work independently
• Adaptable, flexible, and able to incorporate frequent process changes into established workflows within a fast-paced, dynamic environment 

*All Telecommuters 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: 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.

#RPO #GREEN

Logo

About Optum

Connections working at Optum

More Jobs from This Employer

https://careers.apha.org/jobs/20805928/case-manager-rn-remote-within-oh-in-or-ky