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 Monday- Friday three days business hours and two days consumer hours from 11am-8pm;as well asone Saturday shift per month.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 resources

This 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.

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.

Required Qualifications:

• Current, unrestricted RN license in the State
• Willingness and ability to obtain additional RN licenses
• 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 environment
• You will be asked to perform this role in an office setting or other company location
• If you need to enter a work site for any reason, you will be 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. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employee must comply with any state and local masking orders.

Preferred Qualifications:

• Bachelor's Degree
• A background in managed care
• Case Management experience
• 5 - 10 years RN experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
• Call Center 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 success

Answer the call touse your diverse knowledge and experience to make health care work better for our patients. Join us and start doingyour 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