Remote Telephonic Case Manager RN, Wausau, WI

Optum

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Requisition Number: 2193196
Job Category: Nursing
Primary Location: Wausau, WI
(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.

 

UMR offers tailored programs designed to enhance clinical outcomes and reduce costs to customers.  UMR offers best-in-class programs and care management services to help customers receive the right care at the right time in the right place.

 

In this role a Disease Management Case Manager will aid in changing our members’ behavior regarding their chronic condition(s). Telephonic interactions with members are structured around behavior change theory and seek to assist individuals make healthy lifestyle changes. Health education and self-advocacy are also key tools in this role.

Available Shifts:

1st Option: 4-days a week/15hrs after 5pm

OFF: Any week day except Friday

2nd Option: 5-days a week/10hrs after 5pm

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

 

Primary Responsibilities:

  • Patient engagement and retention in specific Disease Management Programs – Diabetes, Hypertension, CAD, Heart Failure, Asthma, COPD, Depression, Breast, Lung, Prostate and Colorectal Cancers, Hepatitis C, HIV, Multiple Sclerosis, ALS, Myasthenia Gravis, Sickle Cell Disease, Rheumatoid Arthritis, Chronic Kidney Disease, Ulcerative Colitis, and Crohn’s Disease
  • Utilizes established standards of care to identify and address members’ gaps in care
  • Utilizing motivational interviewing techniques for assisting members to move through the stages of behavioral change
  • Working with members to set and achieve SMART goals
  • Coaching individuals to make lifestyle changes to reduce risk of disease processes
  • Exercise clinically sound judgment using relevant information, expertise, and decision support tools when interacting with members
  • Achieve productivity standards as established
  • Document clinical information completely, accurately and in a timely manner
  • Perform data collection and quality monitoring activities as required
  • Establish collaborative working relationships with members, providers, and customers
  • Demonstrate sensitivity to issues and show pro-active behavior in addressing customer/member needs
  • Ensure that sensitive member medical information is treated with respect and appropriate levels of confidentiality and adherence to HIPAA regulations
  • Educate and empower members to ensure treatment adherence, satisfaction of management of condition, and promote member advocacy
  • Identify compliance and quality improvement opportunities, and initiate corrective actions
  • Adheres to corporate requirements related to industry regulations/responsibilities
  • Maintain confidentiality and adheres to HIPAA requirements

 

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:

  • RN license, active and unrestricted, in the state of residence
  • Active compact license
  • Ability to obtain multi-state RN Licensure
  • 5+ years clinical experience  (clinical knowledge/experience)
  • Access to high speed internet (DSL or Cable)
  • Dedicated work area established that is separated from other living areas and provides information privacy
  • Computer skills and proficiency in MS Office applications
  • Proven independence with problem solving and daily work prioritization

 

Preferred Qualifications:

  • BSN degree or higher
  • CCP certified Chronic Care provider
  • Experience working in Case Management or Disease Management
  • Motivational interviewing and coaching experience
  • Bilingual with English/Spanish

 

California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington 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