Registered Nurse (RN) Case Manager

  • Optum
  • Washington, DC, USA
  • Nov 21, 2021

Job Description

Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work.SM

$5,000 Sign on Bonus for External applicants!!

You push yourself to reach higher and go further. Because for you, it's all about ensuring a positive outcome for patients. In this role, you'll work in the field and coordinate the long-term care needs for patients in the local community. And at every turn, you'll have the support of an elite and dynamic team. Join UnitedHealth Group and our family of businesses and you will use your diverse knowledge and experience to make health care work better for our patients.

The United Healthcare at Home program is a longitudinal, integrated care delivery program that coordinates the delivery and provision of clinical care of members in their place of residence. The DSNP program combines clinicians providing intensive interventions customized to the needs of each individual, in collaboration with the Interdisciplinary Care Team, which includes the clinician, the member's Primary Care Provider and other providers, and other professionals.

If you are located in the District of Columbia, you will have the flexibility to telecommute* as you take on some tough challenges. Expect to spend about 50-75% of your time in the field visiting our members in their homes or in long-term care facilities in the local area. You'll need to be flexible, adaptable and, above all, patient in all types of situations.

Core Position Hours: Monday - Friday, 8:00am - 5:00pm

Primary Responsibilities:

  • Assess, plan and implement care management interventions that are individualized for each patient and directed toward the most appropriate, least restrictive level of care
  • Identify and initiate referrals for both healthcare and community-based services; including but not limited to financial, psychosocial, community and state supportive services
  • Develop and implement care plan interventions throughout the continuum of care as a single point of contact
  • Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
  • Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team
  • Identify appropriate interventions and resources to meet gaps (e.g., psychosocial, transportation, long-term care) based on specific consumer needs from both the health care and psychosocial / socioeconomic dimensions of care
  • Document the plan of care in appropriate EHR systems and enter data per specified
  • Maintain consumer engagement by establishing rapport, demonstrating empathy, and building a trusting relationship
  • Collaborate with primary providers or multidisciplinary team to align or integrate goals to plan of care and drive consistent coordination of care
  • Provide ongoing support for advanced care planning.
  • Reassess plan of care at appropriate intervals based on initial objectives, significant change of condition, or achievement of goals
  • Understand and operate effectively/efficiently within legal/regulatory requirements
  • Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standard)

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 Registered Nurse (RN) license
  • 1+ years of experience working within the community health setting in a health care facility
  • 1+ years of experience providing community-based care management to members receiving long-term care, personal care services, private duty nursing, or home health
  • Demonstrated competency working with Enrollees and/or families who require intensive case management services
  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements, and will obtain necessary proof of vaccination prior to employment to ensure compliance.

Preferred Qualifications:

  • Resident of the District of Columbia strongly preferred; consideration will be given to those outside of the District of Columbia within commutable distance
  • Experience in managing populations with complex medical or behavioral needs
  • Experience working with Home Care Based Services and/or patients in community and home-based settings
  • Experience with case management, utilization review, discharge planning, concurrent review and/or risk management
  • Certified Case Manager (CCM) certification
  • Prior field-based work experience

Additional Considerations:

  • Knowledge of and experience with D.C. community organizations that offer resources that meet the needs of Enrollees and their families
  • Knowledge of and experience with Medicaid LTSS and behavioral health services and service systems
  • Ability to travel in assigned region to visit Dual Special Needs Plan members in their homes and/or other settings, including community centers, hospitals or providers' offices
  • Strong computer skills including EHR documentation, MS Office, etc.
  • You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Type: Full-time

Benefits:

  • 401(k)
  • Health insurance
  • Paid time off
  • Vision insurance

Schedule:

  • 8 hour shift

Supplemental Pay:

  • Signing bonus

Experience:

  • Nursing: 1 year (Preferred)

License/Certification:

  • RN (Required)

Work Location: One location