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Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.
Optum offers a wide range of career opportunities across clinical and non-clinical roles. As a partner of a statewide healthcare system in Maine, we are committed to delivering personalized, streamlined care to our communities. Whether you’re drawn to a large medical center, a rural practice, or home care, you’ll find your place with us. Our culture is rooted in compassion, meaningful benefits, and a shared mission of caring, connecting, and growing together. The Care Manager, RN plays a key role in coordinating patient-centered care, ensuring safe discharges, and optimizing transitions through collaboration with patients, caregivers, and the healthcare team. This position supports flexible telecommuting from anywhere in the U.S. while tackling impactful healthcare challenges.
The Care Manager, RN provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients/caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Facilitates appropriate LOS, patient experience, and reimbursement for all patients. Develops and maintains collaborative relationships with all members of the healthcare team. Through clinical care coordination drives efficient utilization of resources to reduce length of stay, improve patient flow and throughput, limits variation by applying innovative and evidence-based practice, and to reduce the risk of readmission.
If you are located in Maine, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
- Collaborates and Communicates Effectively: Engages directly with staff, physicians, patients, and families to coordinate care, resolve issues, and ensure clear, respectful communication across all levels
- Leads by Example: Demonstrates leadership through professionalism, courtesy, and efficiency while functioning independently and managing time for maximum productivity
- Coordinates Quality Patient Care: Oversees care processes to achieve optimal outcomes, ensures appropriate resource use, and facilitates patient and family education to support continuity of care
- Manages Utilization and Compliance: Applies knowledge of federal/state regulations, Medicare, and managed care plans to support appropriate length of stay and reimbursement; escalates unresolved cases as needed
- Plans and Facilitates Continuum of Care: Develops and implements discharge plans for complex cases, collaborates with interdisciplinary teams, and ensures timely transitions to the next level of care
- Supports Risk Management and Flexibility: Identifies and addresses potential risk issues, participates in quality improvement initiatives, and remains adaptable to meet hospital needs across all patient age groups
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 of residence
- 2+ years of experience in a hospital case management role
- 1 year of experience post-acute care
- Intermediate level of proficiency to type and navigate a Windows based environment
Preferred Qualifications:
- Certified Case Manager (CCM)
- Background in managed care
- Case management experience
- Skilled nursing facility or Long – Term Care experience
- Experience or exposure to discharge planning
- Experience in utilization review and concurrent review
- Knowledge/understanding of community resources, policies, and procedures
- Knowledge of Utilization Review, Medicare Requirements processes as well as State and Federal regulations pertaining to Utilization Review and Discharge Planning
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.
