Remote Case Manager RN – Metairie, LA Market

Requisition Number: 2188943
Job Category: Nursing
Primary Location: Metairie, LA
(Remote considered)

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

As part of the patient centered medical home team, the RN Care Manager engages in a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet a patient’s health needs through communication and available resources to promote quality, cost-effective outcomes.

The RN Care Manager collaborates with clinical teams in various health care settings in support of the patient, to include acute care, skilled nursing care setting, long term acute care setting, rehab facilities, custodial care, ambulatory care settings, and the patient’s home.  The RN Care Manager will facilitate the coordination of care resulting in more efficient utilization of health care resources, decreased hospital readmissions and improved health outcomes.

If you are located within a commutable distance of either Metairie or New Orleans as this is a Hybrid role and candidates will be in the office three days per week., you will have the flexibility to work remotely* as you take on some tough challenges

Primary Responsibilities:

• Discharge Planning: Works with facility navigator to coordinate DC process and transition needs based on patient’s diagnoses and status
• Care Coordination and Patient Support:
  • Collaboration with the entire clinic team to proactively manage high risk patients by ensuring appropriate:
    • Frequency of PCP visits, Specialist referrals, Testing/screenings
    • Medication Management to include medication reconciliation post discharge and medication adherence
    • Chronic disease education
  • Coordinate home visits when necessary to assess patient’s needs
  • Providing self-management support to patients in order to improve their health outcomes
• Utilization Management:
  • Review Home Health recertification for necessity
  • Assessing appropriate use of services: Emergency room, admissions and re-admissions
  • Review utilization reports to determine possible interventions/care coordination
• Clinic Team Communication: Leads daily/weekly/monthly discussions where patients’ goals, outcomes, interventions, and recommendations for improvement are discussed with members of the patient’s care team.
• Clinic Support: Assist in Clinic Daily Duties as needed

Core Competencies:

• Professionalism
• Excellent written and oral communication skills
• Critical thinking /sound judgment
• Solid problem solving and organizational skills
• Self-Motivated and able to carry out assignments with minimal assistance
• Ability to work well with a diverse group of people
• Ability to prioritize
• Ability to lead a team to accomplish quality goals and initiatives

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 RN license
• Registered Nurse License
• 3+ years of experience in a clinical setting
• Knowledge of computers
• Thorough knowledge of HIPAA compliance

Preferred Qualifications:

• Current CPR certification
• Disease Management, Chronic Care Improvement, and /or Quality Improvement experience in a manage care setting
• Experience with EMR highly

Physical Demands/Working Conditions:

• Ability to travel by personal vehicle between various hospitals and member’s residence on a routine basis
• Must be available to work extended hours, overtime and non-traditional hours as needed

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

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.