Requisition Number: 2184163
Job Category: Medical & Clinical Operations
Primary Location: Gainesville, FL
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 a RN Case Manager, you’ll wear many hats, and work in a variety of environments. Sometimes, you’ll interact with members leaving the hospital – possibly with new medications or diagnoses. Or perhaps you’ll perform home visits, assisting members with safe, effective transitions from care environments to where they live. You may also act as an intermediary between providers and members – serving in numerous roles, such as educator, evaluator, service coordinator, community resource researcher and more. The result? Fewer hospitalizations, ER visits and costly service gaps; and a less stressed, more effective health care system for us all. Want more flexibility, want more autonomy? Work from your own home and coordinate a visiting schedule that is mutually beneficial to you and the members we serve.
What makes your clinical career greater with UnitedHealth Group? You’ll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you’ll open doors for yourself that simply do not exist in any other organization, anywhere.
This is a work from home position working with the Healthy First Steps Program. Employee must reside in the state of Florida, in the greater Gainesville, Jacksonville or Tampa areas. This position will be working with high risk OB population.
If you are residing in Florida, you will have the flexibility to work remotely* as you take on some tough challenges.
- Making outbound calls to assess members’ current health status (potential for field visits as well)
- Take incoming calls from members
- Identifying gaps or barriers in treatment plans
- Providing patient education to assist with self-management
- Interacting with Medical Directors on challenging cases
- Coordinating care for members
- Making referrals to outside sources
- Coordinating services as needed (home health, DME, etc.)
- Educating members on disease processes
- Encouraging members to make healthy lifestyle changes
- Documenting and tracking findings
- Making ‘welcome home’ calls to ensure that discharged member receive the necessary services and resources
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.
- Active, unrestricted RN license in the State of Florida
- 3+ years of experience in a hospital setting, acute care, direct care experience (OB and / or Maternity)
- Proficient level of experience with Microsoft Office including Word, Excel and Outlook, with the ability to navigate a Windows environment.
- Proven solid organizational skills and multitasking abilities
- Proven solid critical thinking skills
- Land line telephone capability within your residence
- Permanent residence in Florida
- Bachelor’s degree
- Certified Case Manager (CCM)
- Experience working with a High Risk population
- Experience working with Maternal / Child Nursing
- Case Management, Utilization Review, discharge planning or other managed care experience
- Knowledge of Florida Community Maternal Child Resources
- Proven bilingual in English / Spanish
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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