7 days old

RN Case Manager East Coast FL - 915067

Port St Lucie, FL 34953
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  • Job Code
    915067

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your lifes best work.(sm)

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This position is East Coast of Florida Based -Treasure Coast or Jacksonville Market andis 75% office / remote based and 25% travel / fieldrole.

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Primary Responsibilities:

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  • Make outbound calls and receive inbound calls to assess members' current health status
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  • Identify gaps or barriers in treatment plans
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  • Provide patient education to assist with self-management
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  • Make referrals to outside sources
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  • Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction
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  • Assist facilities with discharge planning for complicated cases
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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 license in the state of employment
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  • 3+ years of experience in a hospital, acute care or direct care setting
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  • 1+ years of Utilization Management experience working in a hospital or with health plan
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  • Experience with Milliman / InterQual guidelines
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  • Must be highly proficient in navigating a Windows based environment
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  • Ability to travel 25%
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  • This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctors diagnosis of disease
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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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  • BSN
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  • A background in managed care
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  • Case management experience
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  • Experience or exposure to discharge planning
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  • Previous experience in a telephonic role and/or field-based role
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Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 380,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity 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, Utilization Management, UM, acute care, discharge Planning, Milliman, InterQual, BSN, CCM, field, travel, Managed Care, Medicare, Treasure Coast, Port St. Lucie, Daytona Beach, Jacksonville, FL, Florida

Posted: 2021-02-23 Expires: 2021-03-25

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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RN Case Manager East Coast FL - 915067

UnitedHealth Group
Port St Lucie, FL 34953

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