23 days old

Case Manager RN - Telecommute in LA - 938863

Metairie, LA 70005 Work Remotely
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  • Job Code
    938863

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

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The SNP (Special Needs Plan) Care Manager is a member of the interdisciplinary care team (ICT); ensures that the dual-eligible member has an individualized care plan (ICP) that is reviewed and approved by the ICT per policies and procedures, and updates the plan as needed for changes in status. The care manager also offers expertise through ongoing follow-up case management, care coordination, and disease process education.

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This is an telephonic / work at home role in Louisiana. This work is mostly done telephonically with minimal travel to the corporate office when needed. If you are located in LA, you will have the flexibility to telecommute* as you take on some tough challenges.

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Primary Responsibilities:

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  • Contacts dual-eligible members to conduct health risk assessment (HRA) of the individual, inclusive of medical, psychosocial, behavioral, cultural and/or spiritual needs to develop a plan of care that includes health literacy, status and deficits, as well as promotes quality outcomes
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  • Communicates with the member and/or care giver to assist with the development of health goals and identify interventions to achieve these goals
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  • Provide patient-centered intervention; such as making and verifying appointments, performing medication and care compliance initiatives;
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  • Arranging and managing transitions in care; such as from hospital discharge to home or to rehab center by supporting treatment adherence and medication compliance
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  • Serves as health coach to educate the member, the family and/or caregiver, about disease status and treatment, plan benefits, community resources, and resource options
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  • Collaborates with members of the interdisciplinary care team and medical director(s) to facilitate appropriate treatment for members
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  • Routinely follows up with member as scheduled to assess progress towards goals
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Youll 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.

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Required Qualifications:

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  • Current Louisiana RN license
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  • 3+ years of nursing experience in a clinical or similar setting
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  • Experience with clinical documentation systems
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  • Experience in assessing members and developing care plans
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  • Experience working with MS Word and Outlook
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Preferred Qualifications:

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  • Bachelors in Nursing
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  • 5+ years of nursing experience in a clinical or similar setting
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  • Case management and/or care coordination experience
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  • Experienced in a managed care setting
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  • Home health experience
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  • Experience in Med/Surge
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  • Experience working with the geriatric population
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  • Understanding of HMO and third-party administration
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  • Knowledge of CMS / NCQA special needs plan requirements
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  • Ability to work in a shared team environment
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Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy

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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.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: RN Coordinator, RN Case Manager, RN, Registered Nurse, Case Management, Case Manager, Case Manage, Care Coordination, Care Coordinator, Long Term Care, Home Health, Med/Surge, CMS, NCQA, SNP, Special Needs Plan, Health Risk Assessments, Managed Care, Geriatric, Insurance, Insurance Industry, Metairie, Houma, Thibodeaux, LA, Louisiana, Peopleshealth

Posted: 2021-07-02 Expires: 2021-08-01

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Case Manager RN - Telecommute in LA - 938863

UnitedHealth Group
Metairie, LA 70005

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