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 consumer shift: 11:00am-8:00pm. 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 resourcesThis 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.
Required Qualifications: Current, unrestricted RN license in the State 3+ years 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 environmentPreferred Qualifications: Bachelor's Degree A background in managed care Case Management experience Certified Case Manager (CCM) 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 successAnswer 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) 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
Internal Number: 748113
About UnitedHealth Group
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.