Remote Optum Guide Call Center Nurse, Multiple Locations

Requisition Number: 2189688
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 Center for Health Navigation Nurse Consigliere 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 Consigliere, you’ll support a diverse member population with education, advocacy, coaching, 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!

This is high volume, customer service environment. You’ll need to be efficient, productive, and thorough dealing with our members over the phone. Solid computer and software navigation skills are critical. You should also be patient-focused and adaptable to changes.

The schedule is Monday – Friday, with variable coverage within team 7am CST – 10pm CST.

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

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, 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
• Documenting and tracking findings
• Making ‘welcome home’ calls to ensure that discharged member receive the necessary services and resources

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:

• Current, unrestricted RN licensure in the state of residence
• Willingness and ability to obtain additional RN licenses
• 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
• Demonstrated basic Microsoft Word proficiency with the ability to navigate a Windows environment
• Demonstrated passion to creatively serve members thru collaboration and big picture thinking

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
• Case Management 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, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington 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.