Remote Behavioral Telephonic Case Management RN

Optum

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Requisition Number: 2188007
Job Category: Medical & Clinical Operations
Primary Location: New York, NY
(Remote considered)

This is a 100% remote opportunity – Monday through Friday 8am – 5pm.

In this Behavioral Telephonic RN role, you will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs.

Primary Responsibilities:

  • Serve as primary care manager for members with complex medical/behavioral needs
  • Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, functional, cultural and socioeconomic (SDOH) domains
  • Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines
  • Identify gaps or barriers in treatment plans
  • Partner and collaborate with internal care team, providers, community resources/partners and leverage expertise to implement care plan
  • Coordinate care for members and services as needed (home health, DME, etc.)
  • Provide education and coaching to support Member self-management of care needs in alignment with evidence-based guidelines; HEDIS/STAR gap closure
  • Provide psycho-education regarding conditions, medications/ medication adherence, provider/ treatment options, healthcare system utilization
  • Help identify presence or exacerbation of behavioral health symptoms that may be influencing / impacting physical health
  • Provide guidance / consultation to other team members regarding physical/behavioral health conditions, best practice and evidence

Required Qualifications:

  • Current, unrestricted NY RN license
  • 2+ years of relevant clinical work experience
  • 3+ years of experience managing needs of complex populations (eg. Medicare, Medicaid)
  • 1+ years of community case management experience coordinating care for individuals with complex needs
  • 1+ years of experience working directly with individuals suffering from behavioral health illnesses (depression, addiction, bi-polar)
  • Applied knowledge of Medicare and Medicaid benefits
  • Ability to navigate a Windows environment, utilize Outlook, and the ability to create, edit, save and send documents utilizing Microsoft Word

Preferred Qualifications:

  • Bachelor’s Degree
  • Certified Case Manager (CCM)
  • Demonstrated experience / additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care
  • Experience working in managed care

New York City, NY Residents Only: The hourly range for New York City residents is $27.07 to $53.08 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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.