Remote Telephonic RN Case Manager – Kidney Resource Services – Honolulu, HI

Requisition Number: 2186027
Job Category: Nursing
Primary Location: Honolulu, HI
(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. 

For those who want to invent the future of health care, here’s your opportunity. We’re going beyond basic care to health programs integrated across the entire continuum of care.

As a Telephonic RN Case Manager for the Kidney Resource Services program, you will be responsible for clinical operations and medical management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating.  You will also be responsible for providing health education, coaching and treatment decision support for members.

***The schedule for this position includes some evening hours where you will be expected to work until approximately 8pm, based on member availability. For example: 11am-8pm OR a split shift 8am-12pm and then 4pm-8pm***

If you are located in Hawaii, you will have the flexibility to work remotely* 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
• Interacting with Medical Directors on challenging cases
• Coordinating care for members and services as needed (home health, DME, etc.)
• Educating members on disease processes
• Encouraging members to make healthy lifestyle changes
• Utilizing Milliman criteria to determine if patients are in the correct hospital setting
• Making “welcome home” calls to ensure that discharged member receive the necessary services and resources
• Documenting and tracking findings

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 licensures (application fees and filing costs 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 the state of Hawaii
• Multiple state licensures (in addition to Compact License if applicable) or ability to obtain multiple state nursing licenses
• 2+ years of RN experience in a hospital, acute care, or direct care setting, or experience as a Telephonic Case Manager for an insurance company
• Renal, Chronic Kidney Disease or Dialysis Care experience as a main focus of your job
• Computer proficiency utilizing MS Office (Word, Excel, PowerPoint and Outlook), including the ability to type and talk at the same time while navigating a Windows environment
• Must reside in a location that can receive a UnitedHealth Group approved high speed internet connection or can leverage existing high-speed internet service
• Access to dedicated workspace from home for in home office set up
• Permanent residence in the state of Hawaii
• Ability to work schedule listed

Preferred Qualifications:

• BSN
• Certified Case Manager (CCM)
• Experience with discharge planning
• ICU, Cardiology or Critical Care experience
• Diabetic educator experience
• Telephonic case management experience
• Solid working knowledge of hypertension and/or diabetes

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