16 days old

On Site RN Case Manager - Community Transitional Center - (Rosecrans) San Diego, CA - 918539

San Diego, CA 92101
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  • Job Code
    918539
  • Jobs Rated
    122nd

Are you ready for your next challenge? Discover it here at UnitedHealth Group and help us reinvent the health system. We're going beyond basic care, providing integrated health programs with a member-centric focus. The challenge is ensuring we deliver the right care at the right time. When you join us as a RN Case Manager, you'll be making a difference in peoples' lives by offering support and assistance to members seeking health education, program referrals or general health services. You will work with patients to manage their health conditions for ultimate outcomes by taking in-bound calls and placing out-bound calls as dictated by consumer and business needs. You will also be working with clients who are recently released from incarceration, assessing their healthcare needs and assisting them in accessing the appropriate care.

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What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. Whether in-person or over-the-phone, we're working to help others live healthier lives while providing an opportunity for you to do your life's best work.(sm)

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This is a 40 hours per week position. 30 hours of the week is spent at the Community Transitional Center in the Rosecrans area of San Diego, where you will review medical records of clients scheduled for release from jail and also assist with case management of those living at the Community Transitional Center. 10 hours per week is spent working from home where you will review prior authorization and pharmacy requests for the San Diego County Medical Services Program.

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Primary Responsibilities:

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  • Assess, plan, implement, coordinate, monitor, and evaluate case management activities for offenders being released from state and local prison and for those currently residing at the Community Transition Center, across the continuum of care, within the scope of the case manager's license, including:
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  • Coordination and service delivery, Physical and psychological factors, Case management concepts and Community resources. Perform pre-release planning for men and women coming out of the prison system
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  • Provide knowledge to probation officers regarding difficult medical cases. Meet with clients who are currently residing at the Community Transition Center for ongoing medical case management
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  • Understand and maintain confidentiality of legal and ethical issues at all times
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  • Check eligibility as per procedure/ client specifications; if there is an eligibility problem, the case manager notifies the caller and consults the case management supervisor
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  • Assess initial clinical information and develop a treatment plan and goals that meet the individual patient's/ client's present needs
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  • Communicate goals and objectives to all pertinent parties
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  • Evaluate and certify all cases for potential complications, and cases that would benefit from alternative care
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  • Assess clinical information at established intervals to evaluate the effectiveness of the case management plan for each patient
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  • Evaluate and communicate the case objectives and goals to the individual patient's case management team. Consult physician advisers to determine the medical necessity and appropriateness of treatment plan goals and objectives
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  • Maintain an open line of communication with all parties of the individual case management treatment team to include patient, probation officer, and other service providers across the continuum of care
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  • Remain aware of and follow all departmental policies and procedures. Answer calls as needed for individual assigned units. Assume other duties as assigned and directed by the case management or other supervisors. Report any quality issues identified to the case management supervisor
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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.

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Required Qualifications:

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  • Current, unrestricted RN licensure in CA
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  • 2+ years of RN experience, resulting in excellent clinical skills and judgment
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  • Effective inbound and outbound telephonic skills
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  • Intermediate computer skills (Microsoft Word, Outlook and Internet) with the ability to navigate a Windows environment and the ability to create, edit, save and send documents utilizing Microsoft Word
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  • Understanding of Case Management and Care Coordination
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  • Proficiency in assessment of needs and the ability to influence and motivate
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  • Conflict management skills
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  • Able to work under pressure and appropriately prioritize responsibilities
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  • You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role
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  • 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
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Preferred Qualifications:

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  • Bachelor's degree in Nursing
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  • Coaching and/or decision support experience
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  • Managed care experience
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  • Case management certification (CCM)
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Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

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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, Registered Nurse, Case Manager, Community Health, Public Health, San Diego, CA, California, CTC, Community Transition Center, Loma Portal, Point Loma, Rosecrans

Jobs Rated Reports for Registered Nurse

Posted: 2021-03-26 Expires: 2021-04-25

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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On Site RN Case Manager - Community Transitional Center - (Rosecrans) San Diego, CA - 918539

UnitedHealth Group
San Diego, CA 92101

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