Remote Telephonic Nurse Case Manager RN – Compact State

Requisition Number: 2187928
Job Category: Nursing
Primary Location: Cheektowaga, NY
(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. As a Telephonic Nurse Case Manager, you’ll support a diverse member population with education, advocacy, 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!

The schedule is Monday – Friday: 3 days/week 8 am – 5 pm, 2 days/week 11 am – 8 pm. The selected candidate(s) must be able to work until 8pm two nights/week.

If you are located in a compact state, you will have the flexibility to work remotely* as you take on some tough challenges. Residency in a compact state is required.

Primary Responsibilities:

• Make outbound calls to assess members’ current health status
• Identify gaps or barriers in treatment plans
• Provide patient education to assist with self-management
• Interact with Medical Directors on challenging cases
• Coordinate care for members
• Make referrals to outside sources
• Coordinate services as needed (i.e., home health, DME, etc.)
• Educate members on disease processes
• Encourage members to make healthy lifestyle changes
• Document and track findings
• Utilize Milliman criteria to determine if patients are in the correct hospital setting
• Make ‘welcome home’ calls to ensure that discharged member receive the necessary services and resources

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 solidly patient-focused and adaptable to changes.

This position will require active and unrestricted nursing licensure in multiple US States. Selected candidate(s) 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:

• Active, unrestricted RN license in state of residence
• Multiple state licensure (in addition to Compact License if applicable) OR the ability to obtain multiple state nursing licenses
• 3+ years of experience in a hospital setting, acute care, direct care, or as a Case Manager at an insurance company
• Computer proficiency including navigating a Windows environment; using MS Outlook; creating, editing, saving, and sending documents in MS Word; talking and typing at the same time; and using multiple applications simultaneously
• Ability to work Monday – Friday: 3 days/week 8 am – 5 pm, 2 days/week 11 am – 8 pm
• Access to install secure, high-speed internet and a dedicated workspace at home
• Reside in a compact state

Preferred Qualifications:

• Bachelor’s Degree
• Certified Case Manager (CCM)
• Home Health experience
• Managed care experience
• Case Management experience
• Experience with / exposure to discharge planning

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. 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