Remote Call Center – Registered Nurse RN

Optum

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Requisition Number: 2207892
Job Category: Nursing
Primary Location: Eden Prairie, MN
(Remote considered)

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

 

We’re making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that’s driving the health care industry forward. The Enhanced Family Support Nurse Advisor, you will work as part of a cohesive team of non-clinical and clinical experts intended to support the whole person care of complex members and their families. As a Nurse Advisor, you’ll support a diverse member population with education, advocacy, coaching, and connections to the resources they need to feel better and get well. You’re encouraged to think broadly and apply clinical knowledge to creatively facilitate care plans and coordination between clinical and nonclinical roles, with an expectation that your clinical discernment drives ideal experiences for those you serve. 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!

The schedule is Monday – Friday, with variable coverage within the team.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 

 

Primary Responsibilities:

  • Make outbound calls to assess members’ current health status; Support inbound triage of complex member care needs via inbound calls with a goal to activate clinically for longer term case management support depending on clinical discernment and member needs or interest
  • Identifying gaps or barriers in treatment plans
  • With an understanding of member’s needs and engagement, adjustable approach to case management that flexes depending on the unique situation or current health literacy of member
  • Providing patient education to assist with self-management, coaching for better outcomes
  • Interacting with the Multidisciplinary team (i.e. Medical Directors, Pharmacists, Social Specialists, Wellness Coaches) on challenging cases
  • Coordinating care for members
  • Making referrals to outside sources
  • Coordinating services as needed (i.e., home health, DME, etc.)
  • Educating members on disease processes
  • Encouraging members to make healthy lifestyle changes
  • Providing clinical oversight to non-clinical care advisor team staff solving barriers to care and insurance issues for complex member insurance issues
  • Triaging complex member care needs via inbound calls, chats or through warm connections by non-clinical member facing staff
  • Documenting and tracking findings
  • 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. The role utilizes clinical processes for resources but includes a heavy emphasis on creative clinical consideration and activation through multiple engagement channels. Conversion in level of support is discerned by each Nurse Advisor, or in collaboration with nonclinical staff. Solid computer and software navigation skills are critical. You should also be patient-focused and adaptable to changes.

This position will require active and unrestricted Nursing licensure in multiple US States. Selected candidate must be willing and able to obtain and maintain multiple state licensure. Application fees and filing costs will be paid for by UHG.

 

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: 

  • Registered Nurse
  • 3+ years of experience as an RN in a hospital setting, acute care, direct care, or as a telephonic Case Manager for an insurance company
  • Case Management experience
  • Willingness and ability to obtain additional RN licenses
  • Basic Microsoft Word proficiency with the ability to navigate a Windows environment

 

Preferred Qualifications: 

  • Bachelor’s Degree
  • Active and unrestricted RN license in the State of Minnesota, or California, or New York or Compact Licensure
  • Certified Case Manager (CCM)
  • Managed Care experience
  • Call Center experience
  • Experience with / exposure to discharge planning
  • Experience with utilization review, concurrent review and/or risk management

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy 

 

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington residents is $28.03 to $54.95 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.