Remote Outpatient RN Case Manager – Las Vegas, NV

UnitedHealthcare

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Requisition Number: 2194312
Job Category: Nursing
Primary Location: Las Vegas, NV
(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. 

The Outpatient RN Case Manager will be responsible for the management and coordination of Case Management services for members with complex needs and requiring complex service. The Outpatient Case Manager works directly with the member, provider(s), facilities and other entities to ensure the most appropriate care is provided. The Case Manager manages members from all contracted product lines.

The Case Manager assesses, plans, implements, coordinates, monitors, crates an individualized care plan meeting NCQA guidelines and evaluates the outcomes, ensuring options and services required to meet the member’s health needs are best utilized. The Case Manager provides advocacy, communication and resource management and promotes quality and cost-effective interventions and outcomes.

** Candidates must be available to work Monday – Friday 8:00 am – 5:00 pm.**

If you are located within commutable distance from the Las Vegas, NV, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • Coordination of member’s care through the health care continuum
  • Collaborate with member, provider, facility and health plan care team (to include PCP, COC, Medical Directors and Community Services) to develop and implement and ongoing plan of care to obtain best outcome
  • Act as resource to SMA and Network providers
  • Provide health education, coaching and treatment decision support for members
  • Ensure NCQA survey ready at all times for all lines of business

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 license RN license in the State of Nevada
  • Ability to obtain nursing licenses in CA, UT and AZ within 6 months of employment
  • 2+ years of clinical experience in a hospital setting; direct patient care experience
  • Intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word and Excel

Preferred Qualifications:

  • Bachelor’s degree
  • RN licensure in CA, UT, LA and/or AZ
  • Certification in Case Management (CCM)
  • 1+ years of case management experience
  • Experience with NCQA, CMS and other regulatory agencies
  • Managed care experience
  • Knowledge of high risk adult disease state management

Nevada Residents Only: The salary range for Nevada residents is $56,300 to $110,400 per year. 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.

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