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 and help people live healthier lives while doing your life's best work.(sm) As the RN Case Manager you will be responsible for the management and coordination of Case Management services for members having complex needs and requiring complex services in Transplant Department. Case Manager works directly with the member, providers(s), facilities and other entities to ensure that the Patient is assisted through all Phases of the Transplant process. The Case Manager manages members from all fully funded product lines. The Case Manager assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the member's health needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes. Primary Responsibilities:Coordination of member's care through the health care continuumCollaborate with member, provider, facility to obtain best outcomeCollaborate with internal members of the health care team, to include PCP, FHS, COC and Medical DirectorCommunicate / Develop / Implement ongoing plan of care in conjunction with member and providersAct as resource to SMA and Network providers, contracted transplant facilities Evaluate, measure and report on outcomesUtilize written criteria to approve, pend, and / or send case to medical director for review
Required Qualifications: Current and unrestricted RN license in the state of Nevada 2+ years case management experience 2+ years of experience working in acute care NCQA, CMS and other regulatory agencies Knowledge of patient care delivery in a managed care environment Completed preceptor training and the ability to mentor others Basic computer skills Preferred Qualifications:Bachelors degree Managed care experience CCM Transplant experience UNOS experience Must have excellent oral and written communication skills Proficiently demonstrates the skills of a Case Manager Ability to teach Demonstrates excellence in case management skills Ability to contribute to the organization's efforts to eliminate racial and ethnic disparities in organizational performance Critical Demonstrated critical thinking skills as a case manager and able to formulate innovative plan of care for complex cases Recognizes others deficits and assists to train / motivate improvement in their skill setsCareers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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. In addition, employees in certain positions are subject to random drug testing. Job Keywords: RN Case Manager, transplant, RN, Registered Nurse, Case Manager, case management, Las Vegas, NV, Nevada
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 t...hey 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.