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Telephonic Case Manager RN - Richardson, TX

Company: UnitedHealth Group Inc.
Location: Richardson
Posted on: May 3, 2021

Job Description:

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

We're making a strong connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today!

Hours will be Monday-Friday three days business hours and two days consumer hours from 11am-8pm; as well as one Saturday shift per month. Position could eventually allow for some work at home light privileges. That would consist of working from a home setting 2 days a week and in the office the remaining 3 days a week.

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 is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Strong computer and software navigation skills are critical. You should also be strongly patient-focused and adaptable to changes.

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
  • Willingness and ability to obtain additional RN licenses
  • 3+ years of RN experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
  • Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment
  • You will be asked to perform this role in an office setting or other company location
  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

  • Bachelor's Degree
  • Certified Case Manager (CCM)
  • 5+ years of RN experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
  • Case Management experience
  • Call Center experience
  • Experience / exposure with discharge planning
  • Experience in utilization review, concurrent review and / or risk management, strong organizational skills and multitasking abilities will be keys to success
  • Background in managed care

Answer the call to use your diverse knowledge and experience to make health care work better for our patients. Join us and start doing your life's best work.(sm)

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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: RN, Case Management, Utilization Review, Richardson, TX, Texas, Registered Nurse, Case Manager, Case Management, Managed Care, Telephonic, Health Care, Healthcare

Keywords: UnitedHealth Group Inc., Richardson , Telephonic Case Manager RN - Richardson, TX, Other , Richardson, Texas

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